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

Author

Berasaluce Gomez, A, Martin-Calvo, N, Boria, F, Manzour, N, Chacon, E, Bizzarri, N, Chiva, L, Martinez, A, Quesada, A, Kucukmetin, A, Vazquez, A, Mandic, A, Casajuana, A, Kavallaris, A, Fagotti, A, Perrone, A, Ferrero, A, Lekuona, A, Uppin, A, Stepanyan, A, Chiofalo, B, Morillas, B, Tauste, C, Andrade, C, Mom, C, Brucker, C, Sarac, C, Vazquez-Vicente, D, Cibula, D, Querleu, D, Erasun, D, Kaidarova, D, Tsolakidis, D, Haidopoulos, D, Golub, D, Bonci, E, Aksahin, E, Goncalves, E, Moratalla, E, Karaman, E, Myriokefalitaki, E, Ghezzi, F, Narducci, F, Roldan, F, Raspagliesi, F, Goffin, F, Grandjean, F, Guyon, F, Demirkiran, F, Fiol, G, Chakalova, G, Mancebo, G, Vorgias, G, Gebauer, G, Meili, G, Hernandez-Cortes, G, Bogani, G, Cordeiro, G, Vujic, G, Mendinhos, G, Trum, H, Bonsang-Kitzis, H, Haller, H, Vergote, I, Zapardiel, I, Aluloski, I, Berlev, I, Pete, I, Kalogiannidis, I, Kotsopoulos, I, Yezhova, I, Diez, J, Feron, J, Scharf, J, Beltman, J, Haesen, J, Ponce, J, Cea, J, Minguez, J, Garcia, J, Arevalo-Serrano, J, Gilabert, J, Alcazar, J, Kukk, K, Galaal, K, Cardenas, L, Pirtea, L, Mereu, L, Anchora, L, Dostalek, L, Klasa, L, Pakizimre, M, Undurraga, M, Jedryka, M, Bernardino, M, Alonso-Espias, M, Martin-Salamanca, M, Cuadra, M, Tavares, M, Malzoni, M, Fehr, M, Luyckx, M, Lanner, M, Leht, M, Meydanli, M, Mallmann, M, Capilna, M, Redecha, M, Mitrovic, M, Maenpaa, M, Guijarro, M, Abdalla, N, Gomes, N, Povolotskaya, N, Badzakov, N, Arencibia, O, Akbayir, O, Cavalle, P, Zusterzeel, P, Rolland, P, Coronado, P, Bharathan, R, Saaron, R, Sousa, R, Fruscio, R, Jach, R, Poka, R, Barrachina, R, Domingo, S, Morales, S, Akgol, S, Fernandez-Gonzalez, S, Aliyev, S, Herrero, S, Fidalgo, S, Prader, S, Smrkolj, S, Petousis, S, Kovachev, S, Turan, T, Toptas, T, Castellanos, T, da Costa, T, Marina, T, Zanagnolo, V, Martin, V, Gonzalez, V, Student, V, Sukhin, V, Berasaluce Gomez A., Martin-Calvo N., Boria F., Manzour N., Chacon E., Bizzarri N., Chiva L., Martinez A., Quesada A., Kucukmetin A., Vazquez A., Mandic A., Casajuana A., Kavallaris A., Fagotti A., Perrone A., Ferrero A., Lekuona A., Uppin A., Stepanyan A., Chiofalo B., Morillas B., Tauste C., Andrade C., Mom C., Brucker C., Sarac C. -P., Vazquez-Vicente D., Cibula D., Querleu D., Erasun D., Kaidarova D., Tsolakidis D., Haidopoulos D., Golub D., Bonci E. -A., Aksahin E., Goncalves E., Moratalla E., Karaman E., Myriokefalitaki E., Ghezzi F., Narducci F., Roldan F., Raspagliesi F., Goffin F., Grandjean F., Guyon F., Demirkiran F., Fiol G., Chakalova G., Mancebo G., Vorgias G., Gebauer G., Meili G., Hernandez-Cortes G., Bogani G., Cordeiro G., Vujic G., Mendinhos G., Trum H., Bonsang-Kitzis H., Haller H., Vergote I., Zapardiel I., Aluloski I., Berlev I., Pete I., Kalogiannidis I., Kotsopoulos I., Yezhova I., Diez J., Feron J. G., Scharf J. -P., Beltman J., Haesen J., Ponce J., Cea J., Minguez J. A., Garcia J., Arevalo-Serrano J., Gilabert J., Alcazar J. L., Kukk K., Galaal K., Cardenas L., Pirtea L., Mereu L., Anchora L. P., Dostalek L., Klasa L., PakizImre M., Undurraga M., Jedryka M., Bernardino M., Alonso-Espias M., Martin-Salamanca M. B., Cuadra M., Tavares M., Malzoni M., Fehr M., Luyckx M., Lanner M., Leht M., Meydanli M., Mallmann M., Capilna M., Redecha M., Mitrovic M., Maenpaa M. M., Guijarro M., Abdalla N., Gomes N., Povolotskaya N., Badzakov N., Arencibia O., Akbayir O., Cavalle P., Zusterzeel P., Rolland P., Coronado P., Bharathan R., Saaron R., Sousa R., Fruscio R., Jach R., Poka R., Barrachina R., Domingo S., Morales S., Akgol S., Fernandez-Gonzalez S., Aliyev S., Herrero S., Fidalgo S., Prader S., Smrkolj S., Petousis S., Kovachev S., Turan T., Toptas T., Castellanos T., da Costa T. D., Marina T., Zanagnolo V., Martin V., Gonzalez V., Student V., Sukhin V., Berasaluce Gomez, A, Martin-Calvo, N, Boria, F, Manzour, N, Chacon, E, Bizzarri, N, Chiva, L, Martinez, A, Quesada, A, Kucukmetin, A, Vazquez, A, Mandic, A, Casajuana, A, Kavallaris, A, Fagotti, A, Perrone, A, Ferrero, A, Lekuona, A, Uppin, A, Stepanyan, A, Chiofalo, B, Morillas, B, Tauste, C, Andrade, C, Mom, C, Brucker, C, Sarac, C, Vazquez-Vicente, D, Cibula, D, Querleu, D, Erasun, D, Kaidarova, D, Tsolakidis, D, Haidopoulos, D, Golub, D, Bonci, E, Aksahin, E, Goncalves, E, Moratalla, E, Karaman, E, Myriokefalitaki, E, Ghezzi, F, Narducci, F, Roldan, F, Raspagliesi, F, Goffin, F, Grandjean, F, Guyon, F, Demirkiran, F, Fiol, G, Chakalova, G, Mancebo, G, Vorgias, G, Gebauer, G, Meili, G, Hernandez-Cortes, G, Bogani, G, Cordeiro, G, Vujic, G, Mendinhos, G, Trum, H, Bonsang-Kitzis, H, Haller, H, Vergote, I, Zapardiel, I, Aluloski, I, Berlev, I, Pete, I, Kalogiannidis, I, Kotsopoulos, I, Yezhova, I, Diez, J, Feron, J, Scharf, J, Beltman, J, Haesen, J, Ponce, J, Cea, J, Minguez, J, Garcia, J, Arevalo-Serrano, J, Gilabert, J, Alcazar, J, Kukk, K, Galaal, K, Cardenas, L, Pirtea, L, Mereu, L, Anchora, L, Dostalek, L, Klasa, L, Pakizimre, M, Undurraga, M, Jedryka, M, Bernardino, M, Alonso-Espias, M, Martin-Salamanca, M, Cuadra, M, Tavares, M, Malzoni, M, Fehr, M, Luyckx, M, Lanner, M, Leht, M, Meydanli, M, Mallmann, M, Capilna, M, Redecha, M, Mitrovic, M, Maenpaa, M, Guijarro, M, Abdalla, N, Gomes, N, Povolotskaya, N, Badzakov, N, Arencibia, O, Akbayir, O, Cavalle, P, Zusterzeel, P, Rolland, P, Coronado, P, Bharathan, R, Saaron, R, Sousa, R, Fruscio, R, Jach, R, Poka, R, Barrachina, R, Domingo, S, Morales, S, Akgol, S, Fernandez-Gonzalez, S, Aliyev, S, Herrero, S, Fidalgo, S, Prader, S, Smrkolj, S, Petousis, S, Kovachev, S, Turan, T, Toptas, T, Castellanos, T, da Costa, T, Marina, T, Zanagnolo, V, Martin, V, Gonzalez, V, Student, V, Sukhin, V, Berasaluce Gomez A., Martin-Calvo N., Boria F., Manzour N., Chacon E., Bizzarri N., Chiva L., Martinez A., Quesada A., Kucukmetin A., Vazquez A., Mandic A., Casajuana A., Kavallaris A., Fagotti A., Perrone A., Ferrero A., Lekuona A., Uppin A., Stepanyan A., Chiofalo B., Morillas B., Tauste C., Andrade C., Mom C., Brucker C., Sarac C. -P., Vazquez-Vicente D., Cibula D., Querleu D., Erasun D., Kaidarova D., Tsolakidis D., Haidopoulos D., Golub D., Bonci E. -A., Aksahin E., Goncalves E., Moratalla E., Karaman E., Myriokefalitaki E., Ghezzi F., Narducci F., Roldan F., Raspagliesi F., Goffin F., Grandjean F., Guyon F., Demirkiran F., Fiol G., Chakalova G., Mancebo G., Vorgias G., Gebauer G., Meili G., Hernandez-Cortes G., Bogani G., Cordeiro G., Vujic G., Mendinhos G., Trum H., Bonsang-Kitzis H., Haller H., Vergote I., Zapardiel I., Aluloski I., Berlev I., Pete I., Kalogiannidis I., Kotsopoulos I., Yezhova I., Diez J., Feron J. G., Scharf J. -P., Beltman J., Haesen J., Ponce J., Cea J., Minguez J. A., Garcia J., Arevalo-Serrano J., Gilabert J., Alcazar J. L., Kukk K., Galaal K., Cardenas L., Pirtea L., Mereu L., Anchora L. P., Dostalek L., Klasa L., PakizImre M., Undurraga M., Jedryka M., Bernardino M., Alonso-Espias M., Martin-Salamanca M. B., Cuadra M., Tavares M., Malzoni M., Fehr M., Luyckx M., Lanner M., Leht M., Meydanli M., Mallmann M., Capilna M., Redecha M., Mitrovic M., Maenpaa M. M., Guijarro M., Abdalla N., Gomes N., Povolotskaya N., Badzakov N., Arencibia O., Akbayir O., Cavalle P., Zusterzeel P., Rolland P., Coronado P., Bharathan R., Saaron R., Sousa R., Fruscio R., Jach R., Poka R., Barrachina R., Domingo S., Morales S., Akgol S., Fernandez-Gonzalez S., Aliyev S., Herrero S., Fidalgo S., Prader S., Smrkolj S., Petousis S., Kovachev S., Turan T., Toptas T., Castellanos T., da Costa T. D., Marina T., Zanagnolo V., Martin V., Gonzalez V., Student V., and Sukhin V.

Abstract

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.

Published
2023

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

Author

Berasaluce Gómez A., Martín-Calvo N., Boria F., Manzour N., Chacón E., Bizzarri N., Chiva L., Martinez A., Quesada A., Kucukmetin A., Vázquez A., Mandic A., Casajuana A., Kavallaris A., Fagotti A., Perrone A., Ferrero A., Lekuona A., Uppin A., Stepanyan A., Chiofalo B., Morillas B., Tauste C., Andrade C., Mom C., Brucker C., Sarac C. P., Vázquez-Vicente D., Cibula D., Querleu D., Erasun D., Kaidarova D., Tsolakidis D., Haidopoulos D., Golub D., Bonci E. A., Aksahin E., Gonçalves E., Moratalla E., Karaman E., Myriokefalitaki E., Ghezzi F., Narducci F., Roldan F., Raspagliesi F., Goffin F., Grandjean F., Guyon F., Demirkiran F., Fiol G., Chakalova G., Mancebo G., Vorgias G., Gebauer G., Meili G., Hernandez-Cortes G., Bogani G., Cordeiro G., Vujić G., Mendinhos G., Trum H., Bonsang-Kitzis H., Haller H., Vergote I., Zapardiel I., Aluloski I., Berlev I., Pete I., Kalogiannidis I., Kotsopoulos I., Yezhova I., Díez J., Feron J. G., Scharf J. P., Beltman J., Haesen J., Ponce J., Cea J., Mínguez J. Á., García J., Arévalo-Serrano J., Gilabert J., Alcazar J. L., Kukk K., Galaal K., Cárdenas L., Pirtea L., Mereu L., Anchora L. P., Dostalek L., Klasa L., PakižImre M., Undurraga M., Jedryka M., Bernardino M., Alonso-Espias M., Martín-Salamanca M. B., Cuadra M., Tavares M., Malzoni M., Fruscio R., Berasaluce Gómez, A, Martín-Calvo, N, Boria, F, Manzour, N, Chacón, E, Bizzarri, N, Chiva, L, Martinez, A, Quesada, A, Kucukmetin, A, Vázquez, A, Mandic, A, Casajuana, A, Kavallaris, A, Fagotti, A, Perrone, A, Ferrero, A, Lekuona, A, Uppin, A, Stepanyan, A, Chiofalo, B, Morillas, B, Tauste, C, Andrade, C, Mom, C, Brucker, C, Sarac, C, Vázquez-Vicente, D, Cibula, D, Querleu, D, Erasun, D, Kaidarova, D, Tsolakidis, D, Haidopoulos, D, Golub, D, Bonci, E, Aksahin, E, Gonçalves, E, Moratalla, E, Karaman, E, Myriokefalitaki, E, Ghezzi, F, Narducci, F, Roldan, F, Raspagliesi, F, Goffin, F, Grandjean, F, Guyon, F, Demirkiran, F, Fiol, G, Chakalova, G, Mancebo, G, Vorgias, G, Gebauer, G, Meili, G, Hernandez-Cortes, G, Bogani, G, Cordeiro, G, Vujić, G, Mendinhos, G, Trum, H, Bonsang-Kitzis, H, Haller, H, Vergote, I, Zapardiel, I, Aluloski, I, Berlev, I, Pete, I, Kalogiannidis, I, Kotsopoulos, I, Yezhova, I, Díez, J, Feron, J, Scharf, J, Beltman, J, Haesen, J, Ponce, J, Cea, J, Mínguez, J, García, J, Arévalo-Serrano, J, Gilabert, J, Alcazar, J, Kukk, K, Galaal, K, Cárdenas, L, Pirtea, L, Mereu, L, Anchora, L, Dostalek, L, Klasa, L, Pakižimre, M, Undurraga, M, Jedryka, M, Bernardino, M, Alonso-Espias, M, Martín-Salamanca, M, Cuadra, M, Tavares, M, Malzoni, M, and Fruscio, R

Subjects
cervical cancer
Abstract

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.

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. Immunohistochemical analysis of 147 cases of low-grade endometrial stromal sarcoma: refining the immunohistochemical profile of LG-ESS on a large, molecularly confirmed series.

Author

Flídrová M, Dundr P, Vránková R, Němejcová K, Cibula D, Poncová R, Michalová K, Bouda J, Laco J, Ndukwe M, Ryś J, Książek M, Berjon A, Zapardiel I, Franin I, Njavro A, Hausnerová J, Bretová P, Židlík V, Klát J, Krasznai ZT, Poka R, Volodko N, Yezhova I, Pilka R, Marek R, Kolnikova G, Krkoška M, Halaška M, Drozenová J, Dolinská D, Kalist V, Bobiński M, Ostrowska-Leśko M, Bizoń M, Sawicki W, Stukan M, Grabowska K, Jędryka M, Poprawski T, Stolnicu S, Căpîlna ME, Špůrková Z, Zikán M, Ciccarone F, Scambia G, Sharashenidze A, Gudadze M, Piatnytska T, Varchak I, and Kendall Bártů M

Abstract

Low-grade endometrial stromal sarcoma (LG-ESS) can present diagnostic challenges, due to its overlapping morphological features with other uterine mesenchymal tumors. Misdiagnosis rates remain significant, and immunohistochemical data for LG-ESS are limited to small series and inconsistent antibody panels. This study aimed to refine the IHC profile of LG-ESS by analyzing a large, molecularly confirmed series of 147 cases using a panel of 24 antibodies, including newer markers like transgelin and smoothelin. CD10 and IFITM1, key endometrial stromal markers, were expressed in 86% (92% of those extensively) and 69% (60% of those extensively) of cases, with fusion-positive tumors showing significantly higher expression. Smooth muscle markers (α-SMA, desmin, h-caldesmon, calponin, transgelin) were variably expressed, predominantly in focal or low-intensity patterns, with α-SMA reaching the highest frequency of expression (44%). However, the intensity of smooth muscle marker expression was usually very low. Smoothelin was rarely expressed. Hormone receptors were frequently positive, with PR showing a higher frequency (92% vs. 83%) and intensity than ER. Markers like S-100, HMB45, and CD117 were largely negative; all tumors were p53 wild-type, with preserved SMARCB1/SMARCA4 expression and ALK and ROS1 negativity. This work represents the largest molecularly validated IHC study on LG-ESS, providing a robust diagnostic profile for routine pathology. By addressing key diagnostic limitations and examining newer markers, our study supports a more standardized approach to diagnosing LG-ESS and underscores the value of immunohistochemical panels, particularly in fusion-negative tumors where diagnosis relies on morphological and immunohistochemical interpretation. These findings contribute critical data for improving diagnostic accuracy., Competing Interests: Declarations. Ethics approval: The study has been approved by the Ethics Committee of General University Hospital in Prague in compliance with the Helsinki Declaration (No. 2140/19 S-IV). The Ethics Committee waived the requirement for informed consent, as according to the Czech Law (Act. no. 373/11, and its amendment Act no. 202/17) it is not necessary to obtain informed consent in fully anonymized studies. Competing interests: All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript., (© 2025. The Author(s).)

Published
2025
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5. SUCCOR quality: validation of ESGO quality indicators for surgical treatment of cervical cancer.

Author

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 MM, Tavares M, Golub D, Perrone AM, Poka R, Zusterzeel PLM, Aluloski I, Goffin F, Haidopoulos D, Haller H, Jach R, Yezhova I, Bernardino M, Bharathan R, Maenpaa MM, Sukhin V, Feron JG, Fruscio R, Kukk K, Ponce J, Demirkiran F, Vorgias G, Povolotskaya N, Coronado Martín PJ, Marina T, Zapardiel I, Bizzarri N, Gorostidi M, Gutierrez M, Manzour N, Berasaluce A, and Martin-Calvo N

Subjects
Humans, Female, Quality Indicators, Health Care, Retrospective Studies, Neoplasm Staging, Neoplasm Recurrence, Local surgery, Hysterectomy, Uterine Cervical Neoplasms pathology
Abstract

Objective: To 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., Methods: In 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., Results: A 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%, p<0.01). Women who were operated on at centers with high compliance with quality indicators had a significantly lower risk of relapse (HR=0.39; 95% CI 0.25 to 0.61; p<0.001). The association was reduced, but remained significant, after further adjustment for conization, surgical approach, and use of manipulator surgery (HR=0.48; 95% CI 0.30 to 0.75; p=0.001) and adjustment for adjuvant therapy (HR=0.47; 95% CI 0.30 to 0.74; p=0.001). Risk of death from disease was significantly lower in women operated on at centers with high adherence to quality indicators (HR=0.43; 95% CI 0.19 to 0.97; p=0.041). However, the association was not significant after adjustment for conization, surgical approach, use of manipulator surgery, and adjuvant therapy., Conclusions: Patients 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., Competing Interests: Competing interests: None declared., (© IGCS and ESGO 2022. No commercial re-use. See rights and permissions. Published by BMJ.)

Published
2022
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6. SUCCOR cone study: conization before radical hysterectomy.

Author

Chacon E, Manzour N, Zanagnolo V, Querleu D, Núñez-Córdoba JM, Martin-Calvo N, Căpîlna ME, Fagotti A, Kucukmetin A, Mom C, Chakalova G, Shamistan A, Gil Moreno A, Malzoni M, Narducci F, Arencibia O, Raspagliesi F, Toptas T, Cibula D, Kaidarova D, Meydanli MM, Tavares M, Golub D, Perrone AM, Poka R, Tsolakidis D, Vujić G, Jedryka MA, Zusterzeel PLM, Beltman JJ, Goffin F, Haidopoulos D, Haller H, Jach R, Yezhova I, Berlev I, Bernardino M, Bharathan R, Lanner M, Maenpaa MM, Sukhin V, Feron JG, Fruscio R, Kukk K, Ponce J, Minguez JA, Vázquez-Vicente D, Castellanos T, Boria F, Alcazar JL, and Chiva L

Subjects
Adult, Databases, Factual, Disease-Free Survival, Female, Humans, Middle Aged, Minimally Invasive Surgical Procedures, Propensity Score, Retrospective Studies, Uterine Cervical Neoplasms pathology, Conization statistics & numerical data, Hysterectomy statistics & numerical data, Neoplasm Recurrence, Local prevention & control, Uterine Cervical Neoplasms surgery
Abstract

Objective: To evaluate disease-free survival of cervical conization prior to radical hysterectomy in patients with stage IB1 cervical cancer (International Federation of Gynecology and Obstetrics (FIGO) 2009)., Methods: A multicenter retrospective observational cohort study was conducted including patients from the Surgery in Cervical Cancer Comparing Different Surgical Aproaches in Stage IB1 Cervical Cancer (SUCCOR) database with FIGO 2009 IB1 cervical carcinoma treated with radical hysterectomy between January 1, 2013, and December 31, 2014. We used propensity score matching to minimize the potential allocation biases arising from the retrospective design. Patients who underwent conization but were similar for other measured characteristics were matched 1:1 to patients from the non-cone group using a caliper width ≤0.2 standard deviations of the logit odds of the estimated propensity score., Results: We obtained a weighted cohort of 374 patients (187 patients with prior conization and 187 non-conization patients). We found a 65% reduction in the risk of relapse for patients who had cervical conization prior to radical hysterectomy (hazard ratio (HR) 0.35, 95% confidence interval (CI) 0.16 to 0.75, p=0.007) and a 75% reduction in the risk of death for the same sample (HR 0.25, 95% CI 0.07 to 0.90, p=0.033). In addition, patients who underwent minimally invasive surgery without prior conization had a 5.63 times higher chance of relapse compared with those who had an open approach and previous conization (HR 5.63, 95% CI 1.64 to 19.3, p=0.006). Patients who underwent minimally invasive surgery with prior conization and those who underwent open surgery without prior conization showed no differences in relapse rates compared with those who underwent open surgery with prior cone biopsy (reference) (HR 1.94, 95% CI 0.49 to 7.76, p=0.349 and HR 2.94, 95% CI 0.80 to 10.86, p=0.106 respectively)., Conclusions: In this retrospective study, patients undergoing cervical conization before radical hysterectomy had a significantly lower risk of relapse and death., Competing Interests: Competing interests: None declared., (© IGCS and ESGO 2022. No commercial re-use. See rights and permissions. Published by BMJ.)

Published
2022
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