Role of adjuvant therapy in intermediate-risk cervical cancer patients – Subanalyses of the SCCAN study

Cibula, David; Akilli, Huseyin; Jarkovsky, Jiri; van Lonkhuijzen, Luc; Scambia, Giovanni; Meydanli, Mehmet; Ortiz, David; Falconer, Henrik; Abu-Rustum, Nadeem; Odetto, Diego; Klát, Jaroslav; dos Reis, Ricardo; Zapardiel, Ignacio; Di Martino, Giampaolo; Presl, Jiri; Laky, Rene; López, Aldo; Weinberger, Vit; Obermair, Andreas; Pareja, Rene; Poncová, Renata; Mom, Constantijne; Bizzarri, Nicolò; Borčinová, Martina; Aslan, Koray; Salcedo Hernandez, Rosa; Fons, Guus; Benešová, Klára; Dostálek, Lukáš; Ayhan, Ali

doi:10.1016/j.ygyno.2023.01.014

Role of adjuvant therapy in intermediate-risk cervical cancer patients – Subanalyses of the SCCAN study

Cibula D., Akilli H., Jarkovsky J., van Lonkhuijzen L., Scambia G., Meydanli M. M., ...Daha Fazla

Gynecologic Oncology, cilt.170, ss.195-202, 2023 (SCI-Expanded, Scopus)

Yayın Türü: Makale / Tam Makale
Cilt numarası: 170
Basım Tarihi: 2023
Doi Numarası: 10.1016/j.ygyno.2023.01.014
Dergi Adı: Gynecologic Oncology
Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, BIOSIS, CAB Abstracts, EMBASE, Veterinary Science Database
Sayfa Sayıları: ss.195-202
Anahtar Kelimeler: Cervical cancer, Intermediate risk, GOG criteria, Radial surgery, Adjuvant treatment, Radiotherapy
Sağlık Bilimleri Üniversitesi Adresli: Evet

Özet

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.