Role of adjuvant therapy in intermediate-risk cervical cancer patients – Subanalyses of the SCCAN study Journal Article
| Authors: | Cibula, D.; Akilli, H.; Jarkovsky, J.; van Lonkhuijzen, L.; Scambia, G.; Meydanli, M. M.; Ortiz, D. I.; Falconer, H.; Abu-Rustum, N. R.; Odetto, D.; Klát, J.; dos Reis, R.; Zapardiel, I.; Di Martino, G.; Presl, J.; Laky, R.; López, A.; Weinberger, V.; Obermair, A.; Pareja, R.; Poncová, R.; Mom, C.; Bizzarri, N.; Borčinová, M.; Aslan, K.; Salcedo Hernandez, R. A.; Fons, G.; Benešová, K.; Dostálek, L.; Ayhan, A. |
| Article Title: | Role of adjuvant therapy in intermediate-risk cervical cancer patients – Subanalyses of the SCCAN study |
| Abstract: | 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. © 2023 Elsevier Inc. |
| Keywords: | adult; cancer survival; controlled study; human tissue; middle aged; survival rate; major clinical study; overall survival; cancer recurrence; adjuvant therapy; cancer patient; disease free survival; cancer staging; antineoplastic agent; hysterectomy; lymph node dissection; paraaortic lymph node; laparoscopic surgery; laparotomy; sentinel lymph node biopsy; tumor volume; pelvis lymphadenectomy; radiotherapy; cohort analysis; surgical approach; retrospective study; risk assessment; uterine cervix cancer; external beam radiotherapy; intermediate risk; radical hysterectomy; cervical cancer; surgical margin; intermediate risk patient; multicenter study (topic); adjuvant treatment; propensity score; cancer prognosis; lymph vessel metastasis; adjuvant chemoradiotherapy; uterine cervix adenocarcinoma; human; female; article; cervical squamous cell carcinoma; gog criteria; radial surgery; cervicotomy |
| Journal Title: | Gynecologic Oncology |
| Volume: | 170 |
| ISSN: | 0090-8258 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2023-03-01 |
| Start Page: | 195 |
| End Page: | 202 |
| Language: | English |
| DOI: | 10.1016/j.ygyno.2023.01.014 |
| PUBMED: | 36706646 |
| PROVIDER: | scopus |
| PMCID: | PMC10281542 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 1 March 2023 -- Source: Scopus |
