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Conization With Lymph Node Assessment in Early-Stage Cervical Cancer: A Systematic Review and Meta-Analysis
Nathália Maria Monteiro Dantas1, Adriana Graca1, Leila Cristina Soares2
1Universidade do Estado do Rio de Janeiro-UERJ, Rio de Janeiro, Brazil.
The Journal of Obstetrics and Gynaecology Research
|August 11, 2026
Summary
Conservative surgery for early cervical cancer shows low recurrence (4-5%) and lymph node metastasis (3-6%). This approach offers a feasible alternative to radical hysterectomy, potentially reducing patient morbidity while maintaining oncologic outcomes.
Area of Science:
- Gynecologic Oncology
- Surgical Oncology
- Evidence-Based Medicine
Background:
- Radical hysterectomy with pelvic lymphadenectomy is standard for early-stage cervical cancer without lymph node involvement.
- This study investigates conservative surgery with lymph node assessment as an alternative treatment.
Purpose of the Study:
- To evaluate tumor recurrence rates following conservative surgery for early-stage cervical cancer.
- To determine the prevalence of lymph node metastasis in patients treated with conization and lymph node assessment.
Main Methods:
- Systematic literature search across major databases (PubMed, EMBASE, LILACS, Cochrane, SCOPUS, Web of Science).
- Meta-analysis of data from 12 studies including 548 women.
- Assessment of heterogeneity and publication bias using funnel plots and Egger's test; sensitivity analyses performed.
Main Results:
- Pooled recurrence rate after conservative surgery was 4% (95% CI: 2%-7%), with low heterogeneity.
- Excluding smaller studies (<30 participants) yielded a slightly higher pooled recurrence of 5% (95% CI: 3.5%-7%).
- Pooled lymph node positivity rate was 3% (no heterogeneity), but significant bias was detected, increasing the estimate to 6% after bias correction.
Conclusions:
- Conservative surgery combined with lymph node evaluation demonstrates low rates of tumor recurrence and lymph node positivity.
- This approach is a feasible alternative to radical hysterectomy, potentially reducing morbidity while preserving oncologic effectiveness.