David Cibula1, Jiri Slama2, Lukáš Dostálek2, Daniela Fischerová2, Anna Germanova2, Filip Frühauf2, Pavel Dundr3, Kristyna Nemejcova3, Jiri Jarkovsky4, Silvie Sebestova5, Andrea Burgetová6, Martina Borčinová2, Roman Kocián2. 1. Gynecologic Oncology Center, Department of Obstetrics and Gynecology, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Apolinarska 18, Prague 2, 12800, Czech Republic. dc@davidcibula.cz. 2. Gynecologic Oncology Center, Department of Obstetrics and Gynecology, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Apolinarska 18, Prague 2, 12800, Czech Republic. 3. Department of Pathology, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Studnickova 2, Prague 2, 12800, Czech Republic. 4. Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Kamenice 126/3, Brno, 62500, Czech Republic. 5. Institute of Health Information and Statistics of the Czech Republic, Palackeho Namesti 4, P.O. Box 60, Prague 2, 12801, Czech Republic. 6. Department of Radiology, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, U Nemocnice 499/2, Prague 2, 12808, Czech Republic.
Abstract
BACKGROUND: Models predicting recurrence risk (RR) of cervical cancer are used to tailor adjuvant treatment after radical surgery. The goal of our study was to compare available prognostic factors and to develop a prognostic model that would be easy to standardise and use in routine clinical practice. METHODS: All consecutive patients with early-stage cervical cancer treated by primary surgery in a single referral centre (01/2007-12/2016) were eligible if assessed by standardised protocols for pre-operative imaging and pathology. Fifteen prognostic markers were evaluated in 379 patients, out of which 320 lymph node (LN)-negative. RESULTS: The best predictive model for the whole cohort entailed a combination of tumour-free distance (TFD) ≤ 3.5 mm and LN positivity, which separated two subgroups with a substantially distinct RR 36% and 6.5%, respectively. In LN-negative patients, a combination of TFD ≤ 3.5 mm and adenosquamous tumour type separated a group of nine patients with RR 33% from the rest of the group with 6% RR. CONCLUSIONS: A newly identified prognostic marker, TFD, surpassed all traditional tumour-related markers in the RR assessment. Predictive models combining TFD, which can be easily accessed on pre-operative imaging, with LN status or tumour type can be used in daily practice and can help to identify patients with the highest RR.
BACKGROUND: Models predicting recurrence risk (RR) of cervical cancer are used to tailor adjuvant treatment after radical surgery. The goal of our study was to compare available prognostic factors and to develop a prognostic model that would be easy to standardise and use in routine clinical practice. METHODS: All consecutive patients with early-stage cervical cancer treated by primary surgery in a single referral centre (01/2007-12/2016) were eligible if assessed by standardised protocols for pre-operative imaging and pathology. Fifteen prognostic markers were evaluated in 379 patients, out of which 320 lymph node (LN)-negative. RESULTS: The best predictive model for the whole cohort entailed a combination of tumour-free distance (TFD) ≤ 3.5 mm and LN positivity, which separated two subgroups with a substantially distinct RR 36% and 6.5%, respectively. In LN-negative patients, a combination of TFD ≤ 3.5 mm and adenosquamous tumour type separated a group of nine patients with RR 33% from the rest of the group with 6% RR. CONCLUSIONS: A newly identified prognostic marker, TFD, surpassed all traditional tumour-related markers in the RR assessment. Predictive models combining TFD, which can be easily accessed on pre-operative imaging, with LN status or tumour type can be used in daily practice and can help to identify patients with the highest RR.
Authors: David Cibula; Lukáš Dostálek; Jiri Jarkovsky; Constantijne H Mom; Aldo Lopez; Henrik Falconer; Anna Fagotti; Ali Ayhan; Sarah H Kim; David Isla Ortiz; Jaroslav Klat; Andreas Obermair; Fabio Landoni; Juliana Rodriguez; Ranjit Manchanda; Jan Kosťun; Ricardo Dos Reis; Mehmet M Meydanli; Diego Odetto; Rene Laky; Ignacio Zapardiel; Vit Weinberger; Klára Benešová; Martina Borčinová; Darwin Pari; Sahar Salehi; Nicolò Bizzarri; Huseyin Akilli; Nadeem R Abu-Rustum; Rosa A Salcedo-Hernández; Veronika Javůrková; Jiří Sláma; Luc R C W van Lonkhuijzen Journal: Eur J Cancer Date: 2021-10-16 Impact factor: 10.002