The annual recurrence risk model for tailored surveillance strategy in patients with cervical cancer

Cibula, David; Dostálek, Lukáš; Jarkovský, Jiří; Mom, Constantijne H.; López, Aldo; Falconer, Henrik; Fagotti, Anna; Ayhan, Ali; Kim, Sarah H.; Ortiz, David Isla; Klát, Jaroslav; Obermair, Andreas; Landoni, Fabio; Rodríguez, J; Manchanda, Ranjit; Kosťun, Ján; Reis, Ricardo dos; Meydanlı, Mehmet Mutlu; Odetto, Diego; Laky, R; Zapardiel, Ignacio; Weinberger, Vít; Benešová, Klára; Borčinová, Martina; Pari, Darwin; Salehi, Sahar; Bizzarri, Nicolò; Akıllı, Hüseyin; Abu‐Rustum, Nadeem R.; Salcedo‐Hernández, Rosa A.; Javůrková, Veronika; Sláma, Jiří; Lonkhuijzen, Luc van

doi:10.1016/j.ejca.2021.09.008

Cited by 29 publications

(14 citation statements)

References 33 publications

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“…Cervical cancer is one of the main causes of women’s cancer-related deaths worldwide ( 15 ). For cervical cancer patients, lymph nodes status is a critical predictor of survival that has been applied to guide clinical treatment ( 16 ). The risk of lymph node metastasis increases per FIGO stage (2009 version), with incidences from 2% (stage IA2) to 14–36% (IB), 38–51% (IIA), and 47% (IIB) in the pelvic region; and from 2% to 5% (stage IB), 10–20% (IIA), 9% (IIB), 13–30% (III), and 50% (IV) in the paraaortic region ( 17 , 18 ).…”

Section: Discussionmentioning

confidence: 99%

Development and Validation of Novel Nomograms to Predict the Overall Survival and Cancer-Specific Survival of Cervical Cancer Patients With Lymph Node Metastasis

Liu

Wang³

et al. 2022

Front. Oncol.

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ObjectiveThe objective of this study was to establish and validate novel individualized nomograms for predicting the overall survival (OS) and cancer-specific survival (CSS) in cervical cancer patients with lymph node metastasis.MethodsA total of 2,956 cervical cancer patients diagnosed with lymph node metastasis (American Joint Committee on Cancer, AJCC N stage=N1) between 2000 and 2018 were included in this study. Univariate and multivariate Cox regression models were applied to identify independent prognostic predictors, and the nomograms were established to predict the OS and CSS. The concordance index (C-index), calibration curves, and receiver operating characteristic (ROC) curves were applied to estimate the precision and discriminability of the nomograms. Decision-curve analysis (DCA) was used to assess the clinical utility of the nomograms.ResultsTumor size, log odds of positive lymph nodes (LODDS), radiotherapy, surgery, T stage, histology, and grade resulted as significant independent predictors both for OS and CSS. The C-index value of the prognostic nomogram for predicting OS was 0.788 (95% CI, 0.762–0.814) and 0.777 (95% CI, 0.758–0.796) in the training and validation cohorts, respectively. Meanwhile, the C-index value of the prognostic nomogram for predicting CSS was 0.792 (95% CI, 0.767–0.817) and 0.781 (95% CI, 0.764–0.798) in the training and validation cohorts, respectively. The calibration curves for the nomograms revealed gratifying consistency between predictions and actual observations for both 3- and 5-year OS and CSS. The 3- and 5-year area under the curves (AUCs) for the nomogram of OS and CSS ranged from 0.781 to 0.828. Finally, the DCA curves emerged as robust positive net benefits across a wide scale of threshold probabilities.ConclusionWe have successfully constructed nomograms that could predict 3- and 5-year OS and CSS of cervical cancer patients with lymph node metastasis and may assist clinicians in decision-making and personalized treatment planning.

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Section: Discussionmentioning

confidence: 99%

Development and Validation of Novel Nomograms to Predict the Overall Survival and Cancer-Specific Survival of Cervical Cancer Patients With Lymph Node Metastasis

Liu

Wang³

et al. 2022

Front. Oncol.

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“…In fact, in a recent article published by our group, we demonstrated that patients with previous cone biopsy operated by MIS have the same outcomes as patients operated by open surgery, 10 which is consistent with previous evidence. 11,12 In another recent study that evaluated relapse risk factors on early cervical cancer after surgery, Cibula et al 13 did not include the previous conization as a potential risk factor, and, logically, it was not evaluated in the univariate and multivariate analyses. Similarly, the LACC trial and subsequent publications discovered the negative impact of the surgical approach (MIS); 8,14 however, no publications considered conization as a potential protective maneuver.…”

Section: Discussionmentioning

confidence: 99%

SUCCOR Risk: Design and Validation of a Recurrence Prediction Index for Early-Stage Cervical Cancer

et al. 2022

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Objective Based on the SUCCOR study database, our primary objective was to identify the independent clinical pathological variables associated with the risk of relapse in patients with stage IB1 cervical cancer who underwent a radical hysterectomy. Our secondary goal was to design and validate a risk predictive index (RPI) for classifying patients depending on the risk of recurrence. Methods Overall, 1116 women were included from January 2013 to December 2014. We randomly divided our sample into two cohorts: discovery and validation cohorts. The test group was used to identify the independent variables associated with relapse, and with these variables, we designed our RPI. The index was applied to calculate a relapse risk score for each participant in the validation group. Results A previous cone biopsy was the most significant independent variable that lowered the rate of relapse (odds ratio [OR] 0.31, 95% confidence interval [CI] 0.17–0.60). Additionally, patients with a tumor diameter >2 cm on preoperative imaging assessment (OR 2.15, 95% CI 1.33–3.5) and operated by the minimally invasive approach (OR 1.61, 95% CI 1.00–2.57) were more likely to have a recurrence. Based on these findings, patients in the validation cohort were classified according to the RPI of low, medium, or high risk of relapse, with rates of 3.4%, 9.8%, and 21.3% observed in each group, respectively. With a median follow-up of 58 months, the 5-year disease-free survival rates were 97.2% for the low-risk group, 88.0% for the medium-risk group, and 80.5% for the high-risk group (p < 0.001). Conclusion Previous conization to radical hysterectomy was the most powerful protective variable of relapse. Our risk predictor index was validated to identify patients at risk of recurrence.

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“…Five risk groups with different prognoses were identified in the model. In conclusion, the model may be a tool for developing the surveillance strategy in this group of patients 9 17…”

Section: Oral Presentationsmentioning

confidence: 99%

“…Dostalek et al assessed the prognostic impact of micrometastases and isolated tumor cells as well. Patients with early-stage cervical cancer (FIGO 2009 stage IA1 LVSI+to IIB) within the Surveillance in Cervical CANcer (SCCAN) retrospective study were included 9. Eighteen percent had metastatic lymph nodes of 969 patients with at least one detected SLN.…”

Section: Oral Presentationsmentioning

confidence: 99%

22nd meeting of the European Society of Gynaecological Oncology (ESGO 2021) report

Razumova

Bizzarri

Pletnev

et al. 2022

Int J Gynecol Cancer

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This is a report from the 22nd Meeting of the European Society of Gynaecological Oncology, held October 23–25, 2021. The 3-day event offered an educational experience covering the major scientific and clinical advances in gynecological oncology. The Congress program included different session formats, including guidelines updates and state-of-the-art lectures. This article provides an overview of the main Congress activities as well as of the most important studies that were presented at the event for the first time.

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The annual recurrence risk model for tailored surveillance strategy in patients with cervical cancer

Cited by 29 publications

References 33 publications

Development and Validation of Novel Nomograms to Predict the Overall Survival and Cancer-Specific Survival of Cervical Cancer Patients With Lymph Node Metastasis

Development and Validation of Novel Nomograms to Predict the Overall Survival and Cancer-Specific Survival of Cervical Cancer Patients With Lymph Node Metastasis

SUCCOR Risk: Design and Validation of a Recurrence Prediction Index for Early-Stage Cervical Cancer

22nd meeting of the European Society of Gynaecological Oncology (ESGO 2021) report

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