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How to predict para-aortic node involvement in advanced cervical cancer? Development of a predictive score. A FRANCOGYN study
- Source :
- EJSO-European Journal of Surgical Oncology, EJSO-European Journal of Surgical Oncology, WB Saunders, 2021, ⟨10.1016/j.ejso.2021.06.036⟩, EJSO-European Journal of Surgical Oncology, 2021, ⟨10.1016/j.ejso.2021.06.036⟩
- Publication Year :
- 2021
-
Abstract
- International audience; INTRODUCTION: Node involvement is one of the main prognostic factors for cervical cancer. Para-aortic lymph node (PALN) assessment is crucial for treating advanced cervical cancer, to define irradiation fields. Objective of this study was to develop a score predicting para-aortic lymph node involvement in patients with advanced cervical cancer. PATIENTS AND METHOD: We performed a multicenter, retrospective, study on 9 French centers from 2000 to 2015, including patients with advanced squamous cell cervix carcinoma who had PALN status assessed by imaging and/or by surgery. Factors associated with a risk of PALN involvement were determined by univariate and multivariate analysis using a logistic regression model. A score was then developed and validated. RESULTS: A total of 1446 patients treated for cervical cancer were included. Of these, 498 had an advanced squamous cell cervical cancer. Ninety-one patients (18.3%) had positive PALN. After univariate and multivariate analysis, tumor size on pelvic MRI, initial SCC, and suspected pelvic node involvement on PET-CT were included in our score. This model allowed the population to be divided into 3 risk groups. Area under the ROC curve of the score was 0.81 (95%CI = 0.72-0.90). In the low-risk group, 9% (28/287) had PALN involvement, whereas in the high-risk group, 43% (22/51) had PALN involvement. CONCLUSION: We developed a simple score predicting PALN involvement in advanced cervical cancers. Three risk groups can be defined, and patients considered to be at low risk may avoid para-aortic staging as well as extensive field irradiation.
- Subjects :
- Oncology
medicine.medical_specialty
Multivariate analysis
[SDV]Life Sciences [q-bio]
Population
Uterine Cervical Neoplasms
Logistic regression
Risk Assessment
03 medical and health sciences
0302 clinical medicine
Predictive Value of Tests
Internal medicine
Positron Emission Tomography Computed Tomography
Medicine
Humans
education
Lymph node
Retrospective Studies
Cervical cancer
education.field_of_study
030219 obstetrics & reproductive medicine
Pelvic MRI
Tumor size
business.industry
Univariate
General Medicine
Middle Aged
medicine.disease
Prognosis
Advanced cervical cancer
3. Good health
medicine.anatomical_structure
Para-aortic lymph node
Predictive model
030220 oncology & carcinogenesis
Lymphatic Metastasis
Carcinoma, Squamous Cell
Surgery
Female
France
business
Subjects
Details
- ISSN :
- 15322157 and 07487983
- Volume :
- 47
- Issue :
- 11
- Database :
- OpenAIRE
- Journal :
- European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
- Accession number :
- edsair.doi.dedup.....d9af653a73d282cdab4c727c090d4774