SUCCOR Nodes: May Sentinel Node Biopsy Determine the Need for Adjuvant Treatment?

Adjuvants, Immunologic; Female; Humans; Male; Neoplasm Recurrence, Local/pathology; Sentinel Lymph Node Biopsy; Lymph Nodes/surgery; Lymph Nodes/pathology; Lymph Node Excision; Lymphatic Metastasis/pathology; Neoplasm Staging; Retrospective Studies; Uterine Cervical Neoplasms/surgery; Uterine Cervical Neoplasms/pathology; Lymph Nodes; Lymphatic Metastasis; Neoplasm Recurrence, Local; Uterine Cervical Neoplasms; Surgery; Oncology

Abstract :

[en] [en] BACKGROUND: The SUCCOR cohort was developed to analyse the overall and disease-free survival at 5 years in women with FIGO 2009 stage IB1 cervical cancer. The aim of this study was to compare the use of adjuvant therapy in these women, depending on the method used to diagnose lymphatic node metastasis. PATIENTS AND METHODS: We used data from the SUCCOR cohort, which collected information from 1049 women with FIGO 2009 stage IB1 cervical cancer who were operated on between January 2013 and December 2014 in Europe. We calculated the adjusted proportion of women who received adjuvant therapy depending on the lymph node diagnosis method and compared disease free and overall survival using Cox proportional-hazards regression models. Inverse probability weighting was used to adjust for baseline potential confounders. RESULTS: The adjusted proportion of women who received adjuvant therapy was 33.8% in the sentinel node biopsy + lymphadenectomy (SNB+LA) group and 44.7% in the LA group (p = 0.02), although the proportion of positive nodal status was similar (p = 0.30). That difference was greater in women with negative nodal status and positive Sedlis criteria (difference 31.2%, p = 0.01). Here, those who underwent a SNB+LA had an increased risk of relapse [hazard ratio (HR) 2.49, 95% confidence interval (CI) 0.98-6.33, p = 0.056] and risk of death (HR 3.49, 95% CI 1.04-11.7, p = 0.042) compared with those who underwent LA. CONCLUSIONS: Women in this study were less likely to receive adjuvant therapy if their nodal invasion was determined using SNB+LA compared with LA. These results suggest a lack of therapeutic measures available when a negative result is obtained by SNB+LA, which may have an impact on the risk of recurrence and survival.

Disciplines :

Oncology

Author, co-author :

Berasaluce Gómez, Arantxa; Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, Spain

Martín-Calvo, Nerea; Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, Spain ; IdiSNA, Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain ; CIBER de Fisiopatología de la Obesidad y la Nutrición, Instituto de Salud Carlos III, Madrid, Spain

Boria, Félix; Department of Obstetrics and Gynecology, Universidad de Navarra Clinic, Madrid, Spain

Manzour, Nabil; Department of Obstetrics and Gynecology, Universidad de Navarra Clinic, Pamplona, Spain

Chacón, Enrique; Department of Obstetrics and Gynecology, Universidad de Navarra Clinic, Pamplona, Spain

Bizzarri, Nicolò; Dipartimento per la Salute della Donna e del Bambino e della Salute Pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS, UOC Ginecologia Oncologica, Rome, Italy

Chiva, Luis; Department of Obstetrics and Gynecology, Universidad de Navarra Clinic, Madrid, Spain. lchiva@unav.es

SUCCOR Study Group included Goffin Frédéric

Other collaborator :

Goffin, Frédéric ; Centre Hospitalier Universitaire de Liège - CHU > > Service de gynécologie-obstétrique (CHR)