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Post-recurrence survival in patients with cervical cancer
D. Cibula, L. Dostálek, J. Jarkovsky, CH. Mom, A. Lopez, H. Falconer, G. Scambia, A. Ayhan, SH. Kim, D. Isla Ortiz, J. Klat, A. Obermair, G. Di Martino, R. Pareja, R. Manchanda, J. Kosťun, R. Dos Reis, MM. Meydanli, D. Odetto, R. Laky, I....
Language English Country United States
Document type Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't
Grant support
P30 CA008748
NCI NIH HHS - United States
- MeSH
- Adenocarcinoma mortality pathology physiopathology therapy MeSH
- Carcinoma, Adenosquamous mortality pathology physiopathology therapy MeSH
- Chemotherapy, Adjuvant MeSH
- Radiotherapy, Adjuvant MeSH
- Asymptomatic Diseases MeSH
- Adult MeSH
- Hysterectomy MeSH
- Middle Aged MeSH
- Humans MeSH
- Neoplasm Recurrence, Local mortality pathology physiopathology therapy MeSH
- Lymph Nodes pathology MeSH
- Survival Rate MeSH
- Multivariate Analysis MeSH
- Uterine Cervical Neoplasms mortality pathology physiopathology therapy MeSH
- Carcinoma, Neuroendocrine mortality pathology physiopathology therapy MeSH
- Prognosis MeSH
- Proportional Hazards Models MeSH
- Carcinoma, Squamous Cell mortality pathology physiopathology therapy MeSH
- Neoplasm Staging MeSH
- Trachelectomy MeSH
- Tumor Burden MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Research Support, N.I.H., Extramural MeSH
BACKGROUND: Up to 26% of patients with early-stage cervical cancer experience relapse after primary surgery. However, little is known about which factors influence prognosis following disease recurrence. Therefore, our aims were to determine post-recurrence disease-specific survival (PR-DSS) and to identify respective prognostic factors for PR-DSS. METHODS: Data from 528 patients with early-stage cervical cancer who relapsed after primary surgery performed between 2007 and 2016 were obtained from the SCANN study (Surveillance in Cervical CANcer). Factors related to the primary disease and recurrence were combined in a multivariable Cox proportional hazards model to predict PR-DSS. RESULTS: The 5-year PR-DSS was 39.1% (95% confidence interval [CI] 22.7%-44.5%), median disease-free interval between primary surgery and recurrence (DFI1) was 1.5 years, and median survival after recurrence was 2.5 years. Six significant variables were identified in the multivariable analysis and were used to construct the prognostic model. Two were related to primary treatment (largest tumour size and lymphovascular space invasion) and four to recurrence (DFI1, age at recurrence, presence of symptoms, and recurrence type). The C-statistic after 10-fold cross-validation of prognostic model reached 0.701 (95% CI 0.675-0.727). Three risk-groups with significantly differing prognoses were identified, with 5-year PR-DSS rates of 81.8%, 44.6%, and 12.7%. CONCLUSIONS: We developed the robust model of PR-DSS to stratify patients with relapsed cervical cancer according to risk profiles using six routinely recorded prognostic markers. The model can be utilised in clinical practice to aid decision-making on the strategy of recurrence management, and to better inform the patients.
Department of Gynecologic Oncology Instituto Nacional de Cancerología Bogotá Colombia
Department of Gynecological Surgery National Institute of Neoplastic Diseases Lima Peru
Gynecologic Oncology Unit La Paz University Hospital IdiPAZ Madrid Spain
Gynecology Medical University of Graz Graz Austria
Gynecology Oncology Center National Institute of Cancerology Mexico Mexico
Institute of Biostatistics and Analyses Faculty of Medicine Masaryk University Brno Czech Republic
Memorial Sloan Kettering Cancer Center USA
Queensland Centre for Gynaecological Cancer The University of Queensland Australia
University Hospital Brno Medical Faculty of Masaryk University Czech Republic
References provided by Crossref.org
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- $a Cibula, David $u Gynecologic Oncology Center, Department of Obstetrics and Gynecology, First Faculty of Medicine, Charles University and General University Hospital (Central and Eastern European Gynecologic Oncology Group, CEEGOG), Prague, Czech Republic. Electronic address: dc@davidcibula.cz
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- $a Post-recurrence survival in patients with cervical cancer / $c D. Cibula, L. Dostálek, J. Jarkovsky, CH. Mom, A. Lopez, H. Falconer, G. Scambia, A. Ayhan, SH. Kim, D. Isla Ortiz, J. Klat, A. Obermair, G. Di Martino, R. Pareja, R. Manchanda, J. Kosťun, R. Dos Reis, MM. Meydanli, D. Odetto, R. Laky, I. Zapardiel, V. Weinberger, K. Benešová, M. Borčinová, F. Cardenas, E. Wallin, L. Pedone Anchora, H. Akilli, NR. Abu-Rustum, SA. Barquet-Muñoz, V. Javůrková, D. Fischerová, LRCW. van Lonkhuijzen
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- $a BACKGROUND: Up to 26% of patients with early-stage cervical cancer experience relapse after primary surgery. However, little is known about which factors influence prognosis following disease recurrence. Therefore, our aims were to determine post-recurrence disease-specific survival (PR-DSS) and to identify respective prognostic factors for PR-DSS. METHODS: Data from 528 patients with early-stage cervical cancer who relapsed after primary surgery performed between 2007 and 2016 were obtained from the SCANN study (Surveillance in Cervical CANcer). Factors related to the primary disease and recurrence were combined in a multivariable Cox proportional hazards model to predict PR-DSS. RESULTS: The 5-year PR-DSS was 39.1% (95% confidence interval [CI] 22.7%-44.5%), median disease-free interval between primary surgery and recurrence (DFI1) was 1.5 years, and median survival after recurrence was 2.5 years. Six significant variables were identified in the multivariable analysis and were used to construct the prognostic model. Two were related to primary treatment (largest tumour size and lymphovascular space invasion) and four to recurrence (DFI1, age at recurrence, presence of symptoms, and recurrence type). The C-statistic after 10-fold cross-validation of prognostic model reached 0.701 (95% CI 0.675-0.727). Three risk-groups with significantly differing prognoses were identified, with 5-year PR-DSS rates of 81.8%, 44.6%, and 12.7%. CONCLUSIONS: We developed the robust model of PR-DSS to stratify patients with relapsed cervical cancer according to risk profiles using six routinely recorded prognostic markers. The model can be utilised in clinical practice to aid decision-making on the strategy of recurrence management, and to better inform the patients.
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