Cervical Conization Dimensions: 2022 Consensus Recommendations

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Professor María Kyrgiou to discuss Cervical Conization Dimensions: 2022 Consensus Recommendations. Professor Mara Kyrgiou is a Professor at Imperial College London and a Consultant Surgeon in Gynaecology and Gynaecological Oncology at the West London Gynaecological Cancer Centre, Imperial Healthcare NHS Trust. She is the Head of Section of Gynaecological Oncology at Imperial College London. Her main clinical interest is minimal access and complex gynaecological cancer surgery. Highlights: - Local treatment techniques for cervical pre-invasive and early invasive disease were previously thought to be interchangeable with regards to treatment failure rates and associated with minor and infrequent complications. - The findings of a network metaanalysis (Athanasiou Lancet Oncology 2022) suggest that more aggressive treatments (i.e., CKC, laser conisation) are associated with lower recurrence rates but higher risk for subsequent preterm birth. - The risk of reproductive morbidity is directly associated with the length of the cone. - This paper by ESGO/EFC/IFCPC describes a consensus terminology of the cone dimensions to make studies addressing effectiveness and safety of SIL/CIN treatment comparable and facilitate their use to tailor surveillance and antenatal management. - The 2022 terminology should replace all previous terminologies, which will facilitate communication between clinicians and foster tailored treatment guidelines that balance obstetrical harm against therapeutic effectiveness. - Universal agreed reporting will further facilitate communications among clinicians and pathologists, promote audit of practice and future research, and improve the quality of future meta-analyses.