# The Predictive Value of Preoperative Histological Risk Factors in Early Cervical Cancer

## TL;DR

This study examines how preoperative histological factors compare to postoperative findings in early cervical cancer and finds limited predictive value for recurrence-free survival.

## Contribution

The study identifies that preoperative histological risk factors do not significantly correlate with postoperative discrepancies or patient outcomes in early cervical cancer.

## Key findings

- Preoperative grading matched postoperative grading in 85.7% of cases.
- Postoperative upgrading occurred in 14.3% of cases with no downgrading observed.
- Discrepancies in histological parameters did not correlate with preclinical risk factors or affect recurrence-free survival.

## Abstract

Background: Cervical cancer is a leading cause of morbidity and mortality among women globally. Currently, treatment is primarily based on tumor staging; however, discrepancies between preoperative and postoperative tumor staging remain a significant challenge and may impact treatment decisions and outcomes. This study aims to investigate the disparity between preoperative and postoperative risk factors in early-stage cervical cancer, with a particular focus on the histopathological parameters and the correlation with preclinical risk factors. Methods: Patients who underwent surgical treatment for an initial diagnosis of primary cervical carcinoma at the University Hospital Cologne in the Department of Gynecology and Obstetrics between 2015 and 2021 were included. A retrospective analysis was conducted to examine variations in histological parameters and their relationships with preclinical risk factors, such as age, BMI, smoking status, and HPV status, along with pretherapeutic diagnostic results. Results: In 85.7% of cases, preoperative grading showed concordance with postoperative grading. Postoperative upgrading was observed in 14.3% of cases with no instances of downgrading. Inconsistent findings were noted for venous invasion (3.6% of cases) and lymphovascular space invasion (6.7% of cases). No significant correlations were found between pre- and postoperative discrepancies and preclinical risk factors or pretherapeutic diagnostics. Kaplan–Meier analyses revealed no impact of discordance in grading (p = 0.559) or lymphatic vessel invasion (p = 0.752) on recurrence-free survival. Conclusions: The analyzed discrepancies were not influenced by preclinical risk factors or pretherapeutic interventions and showed no significant prognostic relevance for the patients’ recurrence-free survival. More robust conclusions would require further studies with larger sample sizes.