这项研究的目的是比较术前放射治疗后进行根治手术和单纯根治手术在宫颈癌2-4厘米的肿瘤（FIGO 2018 IB2）中的治疗效果。SENTICOL I和SENTICOL II是2005年至2012年期间评估早期宫颈癌淋巴结前哨探测的两项法国前瞻性多中心试验。根据各中心的自主决定，术前放射治疗（低剂量率或脉冲剂量率，剂量为60Gy）可在根治手术前6-8周进行。回顾性分析SENTICOL I和SENTICOL II队列，比较IB2宫颈肿瘤患者的术前放射治疗或直接手术治疗的治疗效果。共纳入了104例患者：55例接受直接根治子宫手术，49例接受术前放射治疗后进行根治子宫手术。术前放射治疗的患者更有可能没有残留病灶（71.4%对25.5%，p < 0.0001），根据Sedlis标准被定义为低风险（83.3%对51.2%，p < 0.0001）。术后辅助治疗需求在术前放射治疗的情况下更低（14.3%对54.5%，p < 0.0001）。术前放射治疗的患者术后出现的≥ 3级并发症更多（24.5%对9.1%，p = 0.03）。术前放射治疗的患者与接受单纯手术治疗的患者相比，5年无病生存率更高，分别为93.6％和74.4％（p = 0.04）。尽管术前放射治疗与术后并发症严重程度显著相关，但手术标本得到了更好的病理特征，并导致更好的IB2宫颈癌5年无病生存率。版权所有©2023 Elsevier Inc.。

The goal of this study was to compare the outcomes of preoperative brachytherapy followed by radical surgery versus radical surgery alone in cervical cancer with tumor between 2 and 4 cm (FIGO 2018 IB2).SENTICOL I and SENTICOL II were two French prospective multicentric trials evaluating sentinel node biopsy in early-stage cervical cancer between 2005 and 2012. Preoperative brachytherapy (low-dose rate or pulse-dose rate at the dose of 60Gy) could be performed 6 to 8 weeks prior to the radical hysterectomy, at the discretion of each center. SENTICOL I and SENTICOL II cohorts were retrospectively analysed to compare the outcomes of preoperative brachytherapy or upfront surgery in patients with IB2 cervical tumor.A total of 104 patients were included: 55 underwent upfront radical hysterectomy and 49 underwent preoperative brachytherapy followed by radical hysterectomy. Patients with preoperative brachytherapy were more likely to have no residual disease (71.4% vs. 25.5%, p < 0.0001) and to be defined as low risk according to Sedlis criteria (83.3% vs. 51.2%, p < 0.0001). Adjuvant treatments were required less frequently in case of preoperative brachytherapy (14.3% vs. 54.5%, p < 0.0001). Patients with preoperative brachytherapy experienced more postoperative complications grade ≥ 3 (24.5% vs. 9.1%, p = 0.03). Patients with preoperative brachytherapy had better 5-year disease-free survival compared to patients who underwent surgery alone, 93.6% and 74.4% respectively (p = 0.04).Although preoperative brachytherapy was significantly associated with more severe postoperative complications, better pathologic features were obtained on surgical specimens and led to a better 5-year disease-free survival in IB2 cervical cancer.Copyright © 2023 Elsevier Inc. All rights reserved.