Which factors predict the effectiveness of adjuvant treatment in patients with non-high-risk early-stage cervical cancer? Ancillary analysis of KGOG-1028
Junhwan Kim , Jieun Jang , Myong Cheol Lim , Moon-Hong Kim , Yun Hwan Kim , Eun Seop Song , Seok Ju Seong , Dong Hoon Suh , Jong-Min Lee , Chulmin Lee , Chel Hun Choi , Sokbom Kang
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引用次数: 0
Abstract
Objective
To identify predictive factors for the effectiveness of adjuvant therapy (AT) in patients with non-high-risk early-stage cervical cancer.
Methods
A retrospective cohort study was conducted using data from the Korean Gynecologic Oncology Group-1028, which included 1109 low-risk and 360 intermediate-risk patients diagnosed with 2018 FIGO stage IB1-IIA cervical cancer from 2000 to 2008. Disease-free survival (DFS) according to AT was evaluated in restricted patients with certain prognostic factors, such as lymphovascular space invasion (LVSI), depth of invasion (DI) of 1/3, tumor size >4 cm, or nonsquamous cell carcinoma (non-SCC). In addition to the prognostic factor of interest, clinicopathologic factors were balanced between the AT-naïve and AT groups using the inverse probability of treatment weighting.
Results
AT was administered to 281 (25.2 %) low-risk patients and 261 (72.5 %) intermediate-risk patients. Positive LVSI, DI of deep 1/3, tumor size >4 cm, and adenocarcinoma histology were significantly prognostic when tested in the AT-naïve group. AT was effective in prolonging DFS in patients with positive LVSI (hazard ratio [HR] = 0.37; 95 % CI, 0.23–0.60), DI of deep 1/3 (HR = 0.29; 95 % CI, 0.17–0.49), and tumor size >4 cm (HR = 0.28; 95 % CI, 0.11–0.70). However, AT was not effective in patients with non-SCC histology (HR = 0.69; 95 % CI, 0.41–1.16).
Conclusions
Patients with non-high-risk early-stage cervical cancer with any of the following conditions, including positive LVSI, DI of deep 1/3, and tumor size >4 cm, can benefit from AT but not those with non-SCC histology.
期刊介绍:
Gynecologic Oncology, an international journal, is devoted to the publication of clinical and investigative articles that concern tumors of the female reproductive tract. Investigations relating to the etiology, diagnosis, and treatment of female cancers, as well as research from any of the disciplines related to this field of interest, are published.
Research Areas Include:
• Cell and molecular biology
• Chemotherapy
• Cytology
• Endocrinology
• Epidemiology
• Genetics
• Gynecologic surgery
• Immunology
• Pathology
• Radiotherapy