{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T22:45:29Z","timestamp":1788993929012,"version":"build-2803163510"},"reference-count":46,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2020,7,5]],"date-time":"2020-07-05T00:00:00Z","timestamp":1593907200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: We aimed to establish a tool predicting parametrial involvement (PI) in patients with early-stage cervical cancer and select a sub-group of patients who would most benefit from a less radical surgery. Methods: We retrospectively reviewed patients from two prospective multicentric databases\u2014SENTICOL I and II\u2014from 2005 to 2012. Patients with early-stage cervical cancer (FIGO 2018 IA with lympho-vascular involvement to IIA1), undergoing radical surgery (hysterectomy or trachelectomy) with bilateral sentinel lymph node (SLN) mapping with no metastatic node or PI on pre-operative imaging, were included. Results: In total, 5.2% patients (11\/211) presented a histologic PI. After univariate analysis, SLN status, lympho-vascular space invasion, deep stromal invasion and tumor size were significantly associated with PI and were included in our nomogram. Our predictive model had an AUC of 0.92 (IC95% = 0.86\u20130.98) and presented a good calibration. A low risk group, defined according to the optimal sensitivity and specificity, presented a predicted probability of PI of 2%. Conclusion: Patients could benefit from a two-step approach. Final surgery (i.e. radical surgery and\/or lymphadenectomy) would depend on the SLN status and the probability PI calculated after an initial conization with bilateral SLN mapping.<\/jats:p>","DOI":"10.3390\/jcm9072121","type":"journal-article","created":{"date-parts":[[2020,7,6]],"date-time":"2020-07-06T09:49:11Z","timestamp":1594028951000},"page":"2121","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Nomogram Predicting the Likelihood of Parametrial Involvement in Early-Stage Cervical Cancer: Avoiding Unjustified Radical Hysterectomies"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0871-1793","authenticated-orcid":false,"given":"Louise","family":"Benoit","sequence":"first","affiliation":[{"name":"Faculty of Medicine, Paris University, 75006 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7561-239X","authenticated-orcid":false,"given":"Vincent","family":"Balaya","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Paris University, 75006 Paris, France"},{"name":"Gynecology Department, Centre Hospitalo-Universitaire Vaudois, 1011 Lausanne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4498-3734","authenticated-orcid":false,"given":"Benedetta","family":"Guani","sequence":"additional","affiliation":[{"name":"Gynecology Department, Centre Hospitalo-Universitaire Vaudois, 1011 Lausanne, Switzerland"},{"name":"University of Lausanne, Department of Gynecology and Obstetrics, 1011 Lausanne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arnaud","family":"Bresset","sequence":"additional","affiliation":[{"name":"Gynecology and Obstetrics Department, Beaujon Hospital, 92110 Clichy, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2973-410X","authenticated-orcid":false,"given":"Laurent","family":"Magaud","sequence":"additional","affiliation":[{"name":"Public Health Department, Hospices Civils de Lyon, 69002 Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helene","family":"Bonsang-Kitzis","sequence":"additional","affiliation":[{"name":"Gynecological and Breast Surgery and Cancerology Center, RAMSAY-G\u00e9n\u00e9rale de Sant\u00e9, H\u00f4pital Priv\u00e9 des Peupliers, 75013 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte","family":"Ng\u00f4","sequence":"additional","affiliation":[{"name":"Gynecological and Breast Surgery and Cancerology Center, RAMSAY-G\u00e9n\u00e9rale de Sant\u00e9, H\u00f4pital Priv\u00e9 des Peupliers, 75013 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrice","family":"Mathevet","sequence":"additional","affiliation":[{"name":"Gynecology Department, Centre Hospitalo-Universitaire Vaudois, 1011 Lausanne, Switzerland"},{"name":"University of Lausanne, Department of Gynecology and Obstetrics, 1011 Lausanne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabrice","family":"L\u00e9curu","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Paris University, 75006 Paris, France"},{"name":"Breast, Gynecology and Reconstructive Surgery Unit, Curie Institute, 75005 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,7,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1006\/gyno.2001.6493","article-title":"How important is removal of the parametrium at surgery for carcinoma of the cervix?","volume":"84","author":"Covens","year":"2002","journal-title":"Gynecol. 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