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1. SUCCOR quality: validation of ESGO quality indicators for surgical treatment of cervical cancer

Author

Felix Boria, Luis Chiva, Enrique Chacon, Vanna Zanagnolo, Anna Fagotti, Ali Kucukmetin, Constantijne Mom, Galina Chakalova, Aliyev Shamistan, Mario Malzoni, Fabrice Narducci, Octavio Arencibia, Francesco Raspagliesi, Tayfun Toptas, David Cibula, Dilyara Kaidarova, Mehmet Mutlu Meydanli, Mariana Tavares, Dmytro Golub, Anna Myriam Perrone, Robert Poka, Petra L M Zusterzeel, Igor Aluloski, Frederic Goffin, Dimitrios Haidopoulos, Herman Haller, Robert Jach, Iryna Yezhova, Margarida Bernardino, Rasiah Bharathan, Minna M Maenpaa, Vladyslav Sukhin, Jean-Guillaume Feron, Robert Fruscio, Kersti Kukk, Jordi Ponce, Fuat Demirkiran, George Vorgias, Natalia Povolotskaya, Pluvio J Coronado Martín, Tiermes Marina, Ignacio Zapardiel, Nicolò Bizzarri, Mikel Gorostidi, Monica Gutierrez, Nabil Manzour, Arantxa Berasaluce, Nerea Martin-Calvo, Boria, F, Chiva, L, Chacon, E, Zanagnolo, V, Fagotti, A, Kucukmetin, A, Mom, C, Chakalova, G, Shamistan, A, Malzoni, M, Narducci, F, Arencibia, O, Raspagliesi, F, Toptas, T, Cibula, D, Kaidarova, D, Meydanli, M, Tavares, M, Golub, D, Perrone, A, Poka, R, Zusterzeel, P, Aluloski, I, Goffin, F, Haidopoulos, D, Haller, H, Jach, R, Yezhova, I, Bernardino, M, Bharathan, R, Maenpaa, M, Sukhin, V, Feron, J, Fruscio, R, Kukk, K, Ponce, J, Demirkiran, F, Vorgias, G, Povolotskaya, N, Coronado Martin, P, Marina, T, Zapardiel, I, Bizzarri, N, Gorostidi, M, Gutierrez, M, Manzour, N, Berasaluce, A, Obstetrics and gynaecology, CCA - Cancer Treatment and quality of life, and Amsterdam Reproduction & Development (AR&D)

Subjects
Settore MED/40 - GINECOLOGIA E OSTETRICIA, Oncology, cervical cancer, gynecologic surgical procedure, Obstetrics and Gynecology, hysterectomy, gynecologic surgical procedures, Women's cancers Radboud Institute for Health Sciences [Radboudumc 17]
Abstract

ObjectiveTo evaluate whether compliance with European Society of Gynaecological Oncology (ESGO) surgery quality indicators impacts disease-free survival in patients undergoing radical hysterectomy for cervical cancer.MethodsIn this retrospective cohort study, 15 ESGO quality indicators were assessed in the SUCCOR database (patients who underwent radical hysterectomy for International Federation of Gynecology and Obstetrics (FIGO) stage 2009 IB1, FIGO 2018 IB1, and IB2 cervical cancer between January 2013 and December 2014), and the final score ranged between 0 and 16 points. Centers with more than 13 points were classified as high-quality indicator compliance centers. We constructed a weighted cohort using inverse probability weighting to adjust for the variables. We compared disease-free survival and overall survival using Cox proportional hazards regression analysis in the weighted cohort.ResultsA total of 838 patients were included in the study. The mean number of quality indicators compliance in this cohort was 13.6 (SD 1.45). A total of 479 (57.2%) patients were operated on at high compliance centers and 359 (42.8%) patients at low compliance centers. High compliance centers performed more open surgeries (58.4% vs 36.7%, pConclusionsPatients with early cervical cancer who underwent radical hysterectomy in centers with high compliance with ESGO quality indicators had a lower risk of recurrence and death.

Published
2022
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2. SUCCOR Nodes: May Sentinel Node Biopsy Determine the Need for Adjuvant Treatment?

Author

Arantxa Berasaluce Gómez MD, Nerea Martín-Calvo MD, Félix Boria MD, Nabil Manzour MD, Enrique Chacón MD, Nicolò Bizzarri MD, Luis Chiva MD, Alejandra, Martinez, Alfonso, Quesada, Ali, Kucukmetin, Alicia, Vázquez, Aljosa, Mandic, Andrea, Casajuana, Andreas, Kavallaris, Anna, Fagotti, Anna, Perrone, Annamaria, Ferrero, Arantxa, Lekuona, Arno, Uppin, Artem, Stepanyan, Benito, Chiofalo, Bibiana, Morillas, Carmen, Tauste, Claudia, Andrade, Constantijne, Mom, Cosima, Brucker, Cosmin-Paul, Sarac, Daniel, Vázquez-Vicente, David, Cibula, Denis, Querleu, Diego, Erasun, Dilyara, Kaidarova, Dimitrios, Tsolakidis, Dimitros, Haidopoulos, Dmytro, Golub, Eduard-Aexandru, Bonci, Elif, Aksahin, Elisabete, Gonçalves, Enrique, Moratalla, Erbil, Karaman, Eva, Myriokefalitaki, Fabio, Ghezzi, Fabrice, Narducci, Fernando, Roldan, Francesco, Raspagliesi, Frédéric, Goffin, Frederic, Grandjean, Frédéric, Guyon, Fuat, Demirkiran, Gabriel, Fiol, Galina, Chakalova, Gemma, Mancebo, George, Vorgias, Gerhard, Gebauer, Gesine, Meili, Gines, Hernandez-Cortes, Giorgio, Bogani, Gloria, Cordeiro, Goran, Vujić, Gustavo, Mendinhos, Hans, Trum, Hélène, Bonsang-Kitzis, Herman, Haller, Ignace, Vergote, Ignacio, Zapardiel, Igor, Aluloski, Igor, Berlev, Imre, Pete, Ioannis, Kalogiannidis, Ioannis, Kotsopoulos, Iryna, Yezhova, Javier, Díez, Feron, Jean G., Jens-Peter, Scharf, Jogchum, Beltman, Jolien, Haesen, Jordi, Ponce, Jorge, Cea, Jose Ángel Mínguez, José, García, Juan, Arévalo-Serrano, Juan, Gilabert, Juan Luis Alcazar, Kersti, Kukk, Khadra, Galaal, Laura, Cárdenas, Laurentiu, Pirtea, Mereu, Liliana, Luigi Pedone Anchora, Lukas, Dostalek, Lukasz, Klasa, Maja, Pakižimre, Manuela, Undurraga, Marcin, Jedryka, Margarida, Bernardino, Maria, Alonso-Espias, María Belén Martín-Salamanca, Maria, Cuadra, Mariana, Tavares, Mario, Malzoni, Mathias, Fehr, Mathieu, Luyckx, Maximilian, Lanner, Meelis, Leht, Mehmet, Meydanli, Michael, Mallmann, Mihai, Căpîlna, Mikulás, Redecha, Milena, Mitrovic, Maenpaa, Minna M., Miriam, Guijarro, Nabil, Abdalla, Nana, Gomes, Natalia, Povolotskaya, Nikola, Badzakov, Octavio, Arencibia, Özgür, Akbayir, Pere, Cavalle, Petra, Zusterzeel, Philip, Rolland, Pluvio, Coronado, Rasiah, Bharathan, Reeli, Saaron, Rita, Sousa, Robert, Fruscio, Robert, Jach, Robert, Poka, Rosa, Barrachina, Santiago, Domingo, Sara, Morales, Sedat, Akgöl, Sergi, Fernandez-Gonzalez, Shamistan, Aliyev, Sofía, Herrero, Soledad, Fidalgo, Sonia, Prader, Špela, Smrkolj, Stamatios, Petousis, Stefan, Kovachev, Taner, Turan, Tayfun, Toptas, Teresa, Castellanos, Teresa Diniz da Costa, Tiermes, Marina, Vanna, Zanagnolo, Victor, Martin, Virginia, Gonzalez, Vladimír Študent &amp, and Vladyslav, Sukhin

Published
2023

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

Author

Manzour, Nabil, Chiva, Luis, Chacón, Enrique, Martin-Calvo, Nerea, Boria, Felix, Minguez, José A, Alcazar, Juan, L, Vanna, Zanagnolo, Denis, Querleu, Mihai, Căpîlna, Anna, Fagotti, Ali, Kucukmetin, Constantijne, Mom, Galina, Chakalova, Shamistan, Aliyev, Mario, Malzoni, Fabrice, Narducci, Octavio, Arencibia, Francesci, Raspagliesi, Tayfun, Toptas, David, Cibula, Dilyara, Kaidarova, Mehmet, Meydanli, Mariana, Tavares, Dmytro, Golub, Anna, Perrone, Robert, Poka, Dimitrios, Tsolakidis, Goran, Vujić, Marcin, Jedryka, Petra, Zusterzeel, Jogchum, Beltman, Frédéric, Goffin, Dimitros, Haidopoulos, Herman, Haller, Robert, Jach, Iryna, Yezhova, Igor, Berlev, Margarida, Bernardino, Rasiah, Bharathan, Maximilian, Lanner, Vladyslav, Sukhin, Jean, G Feron, Robert, Fruscio, Kersti, Kukk, Jordi, Ponce, Nabil, Abdalla, Özgür, Akbayir, Sedat, Akgöl, Elif, Aksahin, Maria, Alonso-Espias, Igor, Aluloski, Claudia, Andrade, Nikola, Badzakov, Rosa, Barrachina, Giorgio, Bogani, Eduard-Aexandru, Bonci, Hélène, Bonsang-Kitzis, Cosima, Brucker, Laura, Cárdenas, Andrea, Casajuana, Pere, Cavalle, Jorge, Cea, Benito, Chiofalo, Gloria, Cordeiro, Pluvio, Coronado, Maria, Cuadra, Javier, Díez, Teresa Diniz da Costa, Santiago, Domingo, Lukas, Dostalek, Fuat, Demirkiran, Diego, Erasun, Mathias, Fehr, Sergi, Fernandez-Gonzalez, Soledad, Fidalgo, Gabriel, Fiol, Khadra, Galaal, José, García, Gerhard, Gebauer, Fabio, Ghezzi, Juan, Gilabert, Nana, Gomes, Elisabete, Gonçalves, Virginia, Gonzalez, Frederic, Grandjean, Miriam, Guijarro, Frédéric, Guyon, Jolien, Haesen, Gines, Hernandez-Cortes, Sofía, Herrero, Imre, Pete, Ioannis, Kalogiannidis, Erbil, Karaman, Andreas, Kavallaris, Lukasz, Klasa, Ioannis, Kotsopoulos, Stefan, Kovachev, Meelis, Leht, Arantxa, Lekuona, Mathieu, Luyckx, Michael, Mallmann, Gemma, Mancebo, Aljosa, Mandic, Tiermes, Marina, Victor, Martin, María Belén Martín-Salamanca, Alejandra, Martinez, Gesine, Meili, Gustavo, Mendinhos, Mereu, Liliana, Milena, Mitrovic, Sara, Morales, Enrique, Moratalla, Bibiana, Morillas, Eva, Myriokefalitaki, Maja, Pakižimre, Stamatios, Petousis, Laurentiu, Pirtea, Natalia, Povolotskaya, Sonia, Prader, Alfonso, Quesada, Mikuláš, Redecha, Fernando, Roldan, Philip, Rolland, Reeli, Saaron, Cosmin-Paul, Sarac, Jens-Peter, Scharf, Špela, Smrkolj, Rita, Sousa, Artem, Stepanyan, Vladimír, Študent, Carmen, Tauste, Hans, Trum, Taner, Turan, Manuela, Undurraga, Arno, Uppin, Alicia, Vázquez, Ignace, Vergote, George, Vorgias, Ignacio, Zapardiel, Amsterdam Reproduction & Development (AR&D), Obstetrics and gynaecology, CCA - Imaging and biomarkers, Manzour, N, Chiva, L, Chacon, E, Martin-Calvo, N, Boria, F, Minguez, J, Alcazar, J, Zanagnolo, V, Querleu, D, Capilna, M, Fagotti, A, Kucukmetin, A, Mom, C, Chakalova, G, Aliyev, S, Malzoni, M, Narducci, F, Arencibia, O, Raspagliesi, F, Toptas, T, Cibula, D, Kaidarova, D, Meydanli, M, Tavares, M, Golub, D, Perrone, A, Poka, R, Tsolakidis, D, Vujic, G, Jedryka, M, Zusterzeel, P, Beltman, J, Goffin, F, Haidopoulos, D, Haller, H, Jach, R, Yezhova, I, Berlev, I, Bernardino, M, Bharathan, R, Lanner, M, Sukhin, V, Feron, J, Fruscio, R, Kukk, K, Ponce, J, Abdalla, N, Akbayir, O, Akgol, S, Aksahin, E, Alonso-Espias, M, Aluloski, I, Andrade, C, Badzakov, N, Barrachina, R, Bogani, G, Bonci, E, Bonsang-Kitzis, H, Brucker, C, Cardenas, L, Casajuana, A, Cavalle, P, Cea, J, Chiofalo, B, Cordeiro, G, Coronado, P, Cuadra, M, Diez, J, da Costa, T, Domingo, S, Dostalek, L, Demirkiran, F, Erasun, D, Fehr, M, Fernandez-Gonzalez, S, Fidalgo, S, Fiol, G, Galaal, K, Garcia, J, Gebauer, G, Ghezzi, F, Gilabert, J, Gomes, N, Goncalves, E, Gonzalez, V, Grandjean, F, Guijarro, M, Guyon, F, Haesen, J, Hernandez-Cortes, G, Herrero, S, Pete, I, Kalogiannidis, I, Karaman, E, Kavallaris, A, Klasa, L, Kotsopoulos, I, Kovachev, S, Leht, M, Lekuona, A, Luyckx, M, Mallmann, M, Mancebo, G, Mandic, A, Marina, T, Martin, V, Martin-Salamanca, M, Martinez, A, Meili, G, Mendinhos, G, Mereu, L, Mitrovic, M, Morales, S, Moratalla, E, Morillas, B, Myriokefalitaki, E, Pakizimre, M, Petousis, S, Pirtea, L, Povolotskaya, N, Prader, S, Quesada, A, Redecha, M, Roldan, F, Rolland, P, Saaron, R, Sarac, C, Scharf, J, Smrkolj, S, Sousa, R, Stepanyan, A, Student, V, Tauste, C, Trum, H, Turan, T, Undurraga, M, Uppin, A, Vazquez, A, Vergote, I, Vorgias, G, and Zapardiel, I

Subjects
cervical cancer, Cevical cancer, Uterine Cervical Neoplasms, Hysterectomy, Prognosis, Risk Assessment, Women's cancers Radboud Institute for Health Sciences [Radboudumc 17], conization, Settore MED/40 - GINECOLOGIA E OSTETRICIA, Oncology, Recurrence, radical hysterectomy, Humans, Female, Surgery, Neoplasm Recurrence, Local, Neoplasm Staging, Retrospective Studies
Abstract

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.

Published
2022
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4. Radical hysterectomy in early cervical cancer in Europe: Characteristics, outcomes and evaluation of ESGO quality indicators

Author

Aliyev Shamistan, Jogchum Jan Beltman, Fabrice Narducci, Juan Luis Alcázar, Iryna Yezhova, Mehmet Mutlu Meydanli, Frédéric Goffin, José Ángel Mínguez, Robert Fruscio, Dmytro Golub, Nerea Martín-Calvo, Mariana Tavares, Anna Fagotti, Robert Jach, Dimitrios Haidopoulos, N Manzour, Margarida Bernardino, E Chacon, Marcin Jędryka, Kersti Kukk, Dimitrios Tsolakidis, Ali Kucukmetin, Denis Querleu, Mihai Emil Căpîlna, Herman Haller, Jordi Ponce, Mario Malzoni, Constantijne H. Mom, Teresa Castellanos, Goran Vujić, Dilyara Kaidarova, Tayfun Toptas, Daniel Vázquez-Vicente, María Alonso-Espías, Luis Chiva, David Cibula, Jean Guillaume Feron, Galina Chakalova, Vladyslav Sukhin, Matías Jurado, Rasiah Bharathan, Vanna Zanagnolo, Igor Berlev, Minna M. Mäenpää, F Boria, Maximilian Lanner, Francesco Raspagliesi, Anna Myriam Perrone, Octavio Arencibia, Petra L.M. Zusterzeel, Róbert Póka, Boria, F, Chiva, L, Zanagnolo, V, Querleu, D, Martin-Calvo, N, CA Pilna, M, Fagotti, A, Kucukmetin, A, Mom, C, Chakalova, G, Shamistan, A, Malzoni, M, Narducci, F, Arencibia, O, Raspagliesi, F, Toptas, T, Cibula, D, Kaidarova, D, Meydanli, M, Tavares, M, Golub, D, Perrone, A, Poka, R, Tsolakidis, D, Vujic, G, Jedryka, M, Zusterzeel, P, Beltman, J, Goffin, F, Haidopoulos, D, Haller, H, Jach, R, Yezhova, I, Berlev, I, Bernardino, M, Bharathan, R, Lanner, M, Maenpaa, M, Sukhin, V, Feron J.,, Fruscio, R, Kukk, K, Ponce, J, Alonso-Espias, M, Minguez, J, Vazquez-Vicente, D, Manzour, N, Jurado, M, Castellanos, T, Chacon, E, Alcazar, J, Boria F., Chiva L., Zanagnolo V., Querleu D., Martin-Calvo N., CA Pilna M.E., Fagotti A., Kucukmetin A., Mom C., Chakalova, G., Shamistan A., Malzoni M., Narducci F., Arencibia O., Raspagliesi F., Toptas T., Cibula D., Kaidarova D., Meydanli M.M., Tavares M., Golub D., Perrone A.M., Poka R., Tsolakidis D., Vujic G., Jedryka M.A., Zusterzeel P.L.M., Beltman J.J., Goffin F., Haidopoulos D., Haller H., Jach R., Yezhova I., Berlev I., Bernardino M., Bharathan R., Lanner M., Maenpaa M.M., Sukhin V., Feron J.-G., Fruscio R., Kukk K., Ponce J., Alonso-Espias M., Minguez J.A., Vazquez-Vicente D., Manzour N., Jurado M., Castellanos T., Chacon E., Alcazar J.L., Obstetrics and gynaecology, CCA - Cancer Treatment and quality of life, and Amsterdam Reproduction & Development (AR&D)

Subjects
0301 basic medicine, medicine.medical_specialty, SLN and lympadenectomy, cervical cancer, hysterectomy, postoperative complications, radiation, medicine.medical_treatment, Population, Uterine Cervical Neoplasms, Physical examination, 03 medical and health sciences, 0302 clinical medicine, Adjuvant therapy, medicine, Humans, postoperative complication, Stage (cooking), Radical Hysterectomy, education, Quality Indicators, Health Care, Cervical cancer, education.field_of_study, Hysterectomy, medicine.diagnostic_test, business.industry, BIOMEDICINA I ZDRAVSTVO. Kliničke medicinske znanosti. Ginekologija i opstetricija, General surgery, BIOMEDICINE AND HEALTHCARE. Clinical Medical Sciences. Gynecology and Obstetrics, Obstetrics and Gynecology, Middle Aged, medicine.disease, Women's cancers Radboud Institute for Health Sciences [Radboudumc 17], Europe, 030104 developmental biology, Settore MED/40 - GINECOLOGIA E OSTETRICIA, Treatment Outcome, Oncology, 030220 oncology & carcinogenesis, Cohort, Female, business, Human
Abstract

IntroductionComprehensive updated information on cervical cancer surgical treatment in Europe is scarce.ObjectiveTo evaluate baseline characteristics of women with early cervical cancer and to analyze the outcomes of the ESGO quality indicators after radical hysterectomy in the SUCCOR database.MethodsThe SUCCOR database consisted of 1272 patients who underwent radical hysterectomy for stage IB1 cervical cancer (FIGO 2009) between January 2013 and December 2014. After exclusion criteria, the final sample included 1156 patients. This study first described the clinical, surgical, pathological, and follow-up variables of this population and then analyzed the outcomes (disease-free survival and overall survival) after radical hysterectomy. Surgical-related ESGO quality indicators were assessed and the accomplishment of the stated recommendations was verified.ResultsThe mean age of the patients was 47.1 years (SD 10.8), with a mean body mass index of 25.4 kg/m2 (SD 4.9). A total of 423 (36.6%) patients had a previous cone biopsy. Tumor size (clinical examination) ConclusionsIn this European cohort, the rate of adjuvant therapy after radical hysterectomy is higher than for most similar patients reported in the literature. The majority of centers were already following the European recommendations even 5 years prior to the ESGO quality indicator implementations.

Published
2021
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