Pathologic Findings From Conization as Predictors of Residual Disease in Stage IA2 Cervical Cancer: Implications for Fertility-Preserving Surgery With Sentinel Lymph Node Biopsy

In patients with stage IA2 cervical cancer, positive ECC and adenocarcinoma histology were significantly associated with residual tumor in the final hysterectomy specimen. Importantly, no residual tumor was observed in patients with both negative ECC and negative endocervical margin, particularly among those with squamous cell carcinoma. These findings suggest that for highly selected patients, especially those with squamous histology, conization ± SLN biopsy may represent a safe and less invasive fertility-preserving alternative to trachelectomy. Further prospective studies are needed to confirm oncologic safety and define appropriate selection criteria, particularly for cases of adenocarcinoma.