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Role of adjuvant therapy in intermediate-risk cervical cancer patients - Subanalyses of the SCCAN study
D. Cibula, H. Akilli, J. Jarkovsky, L. van Lonkhuijzen, G. Scambia, MM. Meydanli, DI. Ortiz, H. Falconer, NR. Abu-Rustum, D. Odetto, J. Klát, R. Dos Reis, I. Zapardiel, G. Di Martino, J. Presl, R. Laky, A. López, V. Weinberger, A. Obermair, R....
Jazyk angličtina Země Spojené státy americké
Typ dokumentu multicentrická studie, časopisecké články, práce podpořená grantem
- MeSH
- adjuvantní radioterapie MeSH
- hysterektomie MeSH
- kombinovaná terapie MeSH
- lidé MeSH
- nádory děložního čípku * patologie MeSH
- prognóza MeSH
- retrospektivní studie MeSH
- staging nádorů MeSH
- Check Tag
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- práce podpořená grantem MeSH
OBJECTIVE: The "intermediate-risk" (IR) group of early-stage cervical cancer patients is characterized by negative pelvic lymph nodes and a combination of tumor-related prognostic risk factors such as tumor size ≥2 cm, lymphovascular space invasion (LVSI), and deep stromal invasion. However, the role of adjuvant treatment in these patients remains controversial. We investigated whether adjuvant (chemo)radiation is associated with a survival benefit after radical surgery in patients with IR cervical cancer. METHODS: We analyzed data from patients with IR cervical cancer (tumor size 2-4 cm plus LVSI OR tumor size >4 cm; N0; no parametrial invasion; clear surgical margins) who underwent primary curative-intent surgery between 2007 and 2016 and were retrospectively registered in the international multicenter Surveillance in Cervical CANcer (SCCAN) study. RESULTS: Of 692 analyzed patients, 274 (39.6%) received no adjuvant treatment (AT-) and 418 (60.4%) received radiotherapy or chemoradiotherapy (AT+). The 5-year disease-free survival (83.2% and 80.3%; PDFS = 0.365) and overall survival (88.7% and 89.0%; POS = 0.281) were not significantly different between the AT- and AT+ groups, respectively. Adjuvant (chemo)radiotherapy was not associated with a survival benefit after adjusting for confounding factors by case-control propensity score matching or in subgroup analyses of patients with tumor size ≥4 cm and <4 cm. In univariable analysis, adjuvant (chemo)radiotherapy was not identified as a prognostic factor in any of the subgroups (full cohort: PDFS = 0.365; POS = 0.282). CONCLUSION: Among patients with IR early-stage cervical cancer, radical surgery alone achieved equal disease-free and overall survival rates to those achieved by combining radical surgery with adjuvant (chemo)radiotherapy.
Department of Gynecologic Oncology Hospital Italiano de Buenos Aires CABA Buenos Aires Argentina
Department of Gynecologic Oncology Instituto Nacional de Cancerología Bogotá Colombia
Department of Gynecological Oncology Barretos Cancer Hospital Barretos São Paulo Brazil
Department of Gynecological Surgery National Institute of Neoplastic Diseases Lima Peru
Gynaecologic Surgical Unit ASST Monza San Gerardo Hospital University of Milano Bicocca Monza Italy
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 Brno Czech Republic
Citace poskytuje 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 Role of adjuvant therapy in intermediate-risk cervical cancer patients - Subanalyses of the SCCAN study / $c D. Cibula, H. Akilli, J. Jarkovsky, L. van Lonkhuijzen, G. Scambia, MM. Meydanli, DI. Ortiz, H. Falconer, NR. Abu-Rustum, D. Odetto, J. Klát, R. Dos Reis, I. Zapardiel, G. Di Martino, J. Presl, R. Laky, A. López, V. Weinberger, A. Obermair, R. Pareja, R. Poncová, C. Mom, N. Bizzarri, M. Borčinová, K. Aslan, RA. Salcedo Hernandez, G. Fons, K. Benešová, L. Dostálek, A. Ayhan
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- $a OBJECTIVE: The "intermediate-risk" (IR) group of early-stage cervical cancer patients is characterized by negative pelvic lymph nodes and a combination of tumor-related prognostic risk factors such as tumor size ≥2 cm, lymphovascular space invasion (LVSI), and deep stromal invasion. However, the role of adjuvant treatment in these patients remains controversial. We investigated whether adjuvant (chemo)radiation is associated with a survival benefit after radical surgery in patients with IR cervical cancer. METHODS: We analyzed data from patients with IR cervical cancer (tumor size 2-4 cm plus LVSI OR tumor size >4 cm; N0; no parametrial invasion; clear surgical margins) who underwent primary curative-intent surgery between 2007 and 2016 and were retrospectively registered in the international multicenter Surveillance in Cervical CANcer (SCCAN) study. RESULTS: Of 692 analyzed patients, 274 (39.6%) received no adjuvant treatment (AT-) and 418 (60.4%) received radiotherapy or chemoradiotherapy (AT+). The 5-year disease-free survival (83.2% and 80.3%; PDFS = 0.365) and overall survival (88.7% and 89.0%; POS = 0.281) were not significantly different between the AT- and AT+ groups, respectively. Adjuvant (chemo)radiotherapy was not associated with a survival benefit after adjusting for confounding factors by case-control propensity score matching or in subgroup analyses of patients with tumor size ≥4 cm and <4 cm. In univariable analysis, adjuvant (chemo)radiotherapy was not identified as a prognostic factor in any of the subgroups (full cohort: PDFS = 0.365; POS = 0.282). CONCLUSION: Among patients with IR early-stage cervical cancer, radical surgery alone achieved equal disease-free and overall survival rates to those achieved by combining radical surgery with adjuvant (chemo)radiotherapy.
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