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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, 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, Zapardiel, I, Manzour N., Chiva L., Chacon E., Martin-Calvo N., Boria F., Minguez J. A., Alcazar J. L., 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. G., 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. -A., 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. D., 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. B., 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. -P., Scharf J. -P., Smrkolj S., Sousa R., Stepanyan A., Student V., Tauste C., Trum H., Turan T., Undurraga M., Uppin A., Vazquez A., Vergote I., Vorgias G., Zapardiel I., 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, Zapardiel, I, Manzour N., Chiva L., Chacon E., Martin-Calvo N., Boria F., Minguez J. A., Alcazar J. L., 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. G., 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. -A., 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. D., 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. B., 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. -P., Scharf J. -P., 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.

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

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

Author

Manzour, N., Chiva, L., Chacon, E., Martin-Calvo, N., Boria, F., Minguez, J. A., Alcazar, J. L., Zanagnolo, V., Querleu, D., Capilna, M., Fagotti, Anna, 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. G., 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. -A., 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. D., 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. B., 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. -P., Scharf, J. -P., Smrkolj, S., Sousa, R., Stepanyan, A., Student, V., Tauste, C., Trum, H., Turan, T., Undurraga, M., Uppin, A., Vazquez, A., Vergote, I., Vorgias, G., Zapardiel, I., Fagotti A. (ORCID:0000-0001-5579-335X), Manzour, N., Chiva, L., Chacon, E., Martin-Calvo, N., Boria, F., Minguez, J. A., Alcazar, J. L., Zanagnolo, V., Querleu, D., Capilna, M., Fagotti, Anna, 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. G., 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. -A., 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. D., 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. B., 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. -P., Scharf, J. -P., Smrkolj, S., Sousa, R., Stepanyan, A., Student, V., Tauste, C., Trum, H., Turan, T., Undurraga, M., Uppin, A., Vazquez, A., Vergote, I., Vorgias, G., Zapardiel, I., and Fagotti A. (ORCID:0000-0001-5579-335X)

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

5. SUCCOR cone study

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, Chiva, L, SUCCOR study group, SUCCOR study Group: Abdalla, N, Akgöl, S, Aksahin, D, Aliyev, S, Alonso-Espias, M, Aluloski, I, Andrade, C, Badzakov, N, Barrachina, R, Bogani, G, Bonci, E-A, Bonsang-Kitzis, H, Brucker, C, Cárdenas, L, Casajuana, A, Cavalle, P, Cea, J, Chiofalo, B, Cordeiro, G, Coronado, P, Cuadra, M, Díez, J, Diniz da Costa, T, Domingo, S, Dostalek, L, Elif, F, Erasun, D, Fehr, M, Fernandez-Gonzalez, S, Ferrero, A, Fidalgo, S, Fiol, G, Galaal, K, García, J, Gebauer, G, Ghezzi, F, Gilabert, J, Gomes, N, Gonçalves, 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, Stefan Kovachev, S, U A, Leht, Lekuona, A, Luyckx, M, Mallmann, M, Mancebo, G, Mandic, A, Marina, T, Martin, V, M B, Martín-Salamanca, Lago, V, Martinez, A, Meili, G, Mendinhos, G, Mereu, L, Mitrovic, M, Morales, S, Moratalla, E, N R, Gómez-Hidalgo, Morillas, B, Myriokefalitaki, E, Pakižimre, M, Petousis, S, Pirtea, L, Povolotskaya, N, Prader, S, Quesada, A, Redecha, M, Roldan, F, Rolland, P, Saaron, R, Sarac, C-P, Scharf, J-P, Smrkolj, S, Sousa, R, Stepanyan, A, Študent, V, Tauste, C, Trum, H, Turan, T, Undurraga, M, Vázquez, A, Vergote, I, Vorgias, G, and Zapardiel, I, Obstetrics and gynaecology, CCA - Cancer Treatment and quality of life, Amsterdam Reproduction & Development (AR&D), Chacon, E, Manzour, N, Zanagnolo, V, Querleu, D, Núñez-Córdoba, J, Martin-Calvo, N, Căpîlna, M, 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, M, Tavares, M, Golub, D, Perrone, A, Poka, R, Tsolakidis, D, Vujić, 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, Minguez, J, Vázquez-Vicente, D, Castellanos, T, Boria, F, Alcazar, J, and Chiva, L

Subjects
Adult, Databases, Factual, cervical cancer, Conization, Obstetrics and Gynecology, Uterine Cervical Neoplasms, Middle Aged, Disease-Free Survival, Women's cancers Radboud Institute for Health Sciences [Radboudumc 17], surgery, Settore MED/40 - GINECOLOGIA E OSTETRICIA, laparoscopes, laparoscope, Oncology, laparotomy, Humans, Minimally Invasive Surgical Procedures, Female, Neoplasm Recurrence, Local, hysterectomy, Propensity Score, Retrospective Studies
Abstract

ObjectiveTo 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).MethodsA 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.ResultsWe 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).ConclusionsIn this retrospective study, patients undergoing cervical conization before radical hysterectomy had a significantly lower risk of relapse and death.

Published
2022
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6. 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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7. Colposcopically Directed Biopsy Before Ablative Treatment Versus Direct Ablative Treatment in Patients With Cervical Oncogenic HPV.

Author

Erasun D, Delcampo AV, DE Castro A, Munoz-Solano A, and Schneider J

Abstract

Background/aim: In the past, the standard of care for women with abnormal cervical cytology has been the performance of colposcopically guided biopsy, followed by conization or large loop excision of the transition zone (LLETZ) where biopsy revealed pre-cancerous or cancerous areas. More straightforward protocols are emerging which advocate performing LLETZ in all women with highly suspicious cytology, suspicious colposcopic impression, or the presence of high-risk oncogenic human papilloma virus (HPV) strains in their cervical swabs. This, theoretically, would reduce the rate of false-negative diagnoses, but at the price of overtreating a significant number of healthy women., Patients and Methods: We retrospectively analyzed cervical cancer screening protocols in two large cohorts of women with high-risk HPV. The study compared outcomes between patients undergoing a colposcopically directed biopsy before LLETZ (n=683) and those proceeding directly to LLETZ without a biopsy (n=136). The primary focus was to assess whether intervening biopsies would reduce unnecessary ablative procedures without compromising the detection of high-grade lesions., Results: The biopsy group had a high false-negative rate, with several high-grade lesions (CIN3) and a case of invasive cancer initially underdiagnosed. Conversely, the direct-to-LLETZ approach, while ensuring no high-grade lesions were missed, led to overtreatment of lower grade lesions., Conclusion: These findings raise concern about the reliance on biopsy results for treatment decisions. Neither protocol was entirely satisfactory, although the more aggressive one avoided the potentially life-threatening consequence of false-negative results. Further research is mandatory to accurately diagnose all cases requiring aggressive treatment, without subjecting healthy women to ablative treatments they do not need., Competing Interests: None., (Copyright 2024, International Institute of Anticancer Research.)

Published
2024
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8. Accuracy of ICG compared with technetium-99 m for sentinel lymph node biopsy in vulvar cancer.

Author

Guijarro-Campillo AR, Padilla-Iserte P, Couso B, Erasun D, Utrilla-Layna J, Arencibia O, Boldo-Roda A, Gilabert-Estellés J, Veiga N, Lago V, Cárdenas-Rebollo JM, and Domingo S

Subjects
Female, Humans, Sentinel Lymph Node Biopsy methods, Technetium, Coloring Agents, Indocyanine Green, Obesity surgery, Lymph Nodes pathology, Vulvar Neoplasms diagnostic imaging, Vulvar Neoplasms surgery, Vulvar Neoplasms pathology, Sentinel Lymph Node pathology
Abstract

Purpose: Sentinel lymph node biopsy with radioactive tracer is the standard-of-care in lymph node status assessment in vulvar cancer. Indocyanine green fluorescence-ICG is a promising detection method, due to its advantages over technetium-99 m. In vulvar cancer, the procedure is controversial due to study heterogeneity and the small sample size in previous studies. This study evaluates ICG sentinel lymph node detection compared with the criterion-standard with technetium (dual modality method)., Methods: Preoperative technetium and intraoperative ICG for sentinel lymph node have been prospectively evaluated in early-stage vulvar cancer. The primary endpoint was to determine accuracy in the detection rate for ICG compared with technetium. Secondary objectives included tracer modality relationship with obesity, tumor size and location., Results: In total, 75 patients participated at 8 centers; 38 had lateral and 37 had midline vulvar tumors. The overall sentinel lymph node detection rate was 85.3 % for technetium and 82.7 % for ICG. For lateral tumors, the detection rate was 84.2 % vs. 89.5 %, while it was 86.5 % vs. 75.7 % for middle tumors, using technetium and ICG, respectively. The median sentinel node harvest was 1.7 (range 1-4), with 24 % metastatic involvement. The sensitivity and positive predictive value for ICG based on the standard technique with technetium was 91.08 % (95 % CI, 83.76-95.84) and 94.8 % (95 % CI, 84.84-96.48), respectively. No significant differences were found comparing the two tracers in patients with midline lesions, obesity (body mass index ≥ 30) and tumor size ≥ 2-4 cm., Conclusion(s): ICG shows comparable performance parameters to the gold-standard of radioisotope localization., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Published
2024
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9. Ki67 and E-cadherin Are Independent Predictors of Long-term Survival in Endometrial Carcinoma.

Author

Martin-Salamanca B, Erasun D, Llorca J, and Schneider J

Subjects
Female, Humans, Ki-67 Antigen metabolism, Prognosis, Cadherins metabolism, Biomarkers, Tumor, Tumor Suppressor Protein p53, Endometrial Neoplasms pathology
Abstract

Background/aim: In previous studies, we identified estrogen receptor, progesterone receptor, Ki67, p53, c-erb-B2, and E-cadherin to be individually associated with the prognosis of endometrial carcinoma. In the present study, we aimed to identify which of the aforementioned are associated with survival after long-term follow-up., Patients and Methods: A total of 106 patients were followed until their demise, or for a median of 120 months in the case of survival (range=84-240 months). At the end of the study, 38 patients had died, and 68 were alive. The association of the studied variables with survival was analyzed by means of a Weibull regression model., Results: A final, restricted model adjusted for age, stage, and histological variety showed both Ki67 and E-cadherin to be independent predictors of a shorter and a longer survival, respectively., Conclusion: Immunohistochemistry for Ki67 and E-cadherin is a cheap and relatively easy-to-interpret laboratory procedure for predicting survival of patients with endometrial carcinoma in clinical practice., (Copyright © 2023 International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)

Published
2023
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10. Low birth weight trends in Organisation for Economic Co-operation and Development countries, 2000-2015: economic, health system and demographic conditionings.

Author

Erasun D, Alonso-Molero J, Gómez-Acebo I, Dierssen-Sotos T, Llorca J, and Schneider J

Subjects
Americas epidemiology, Asia epidemiology, Europe epidemiology, Female, Health Personnel statistics & numerical data, Hospitals statistics & numerical data, Humans, Infant, Newborn, Insurance, Health, Physicians, Pregnancy, Public Health statistics & numerical data, Delivery of Health Care statistics & numerical data, Infant, Low Birth Weight, Organisation for Economic Co-Operation and Development, Socioeconomic Factors
Abstract

Background: Low birth weight rates are increasing in both developed and developing countries. Although several maternal factors have been identified as associated with low birth weight, little is known of economic or organization factors influencing this increase. This study aims to ascertain the twenty-first century relationships between the contextual country factors and low birth weight rates., Methods: We analyse trends of low birth weight rates in Organisation for Economic Co-operation and Development (OECD) countries. Data from 2000 to 2015 were obtained from the OECD data base. Their relationships with demographic and economic variables, health habits, woman-related preventive measures, health care system organization and funding, health care work force and obstetric care were analysed using random-effects linear regression., Results: Low birth weight rates are higher in Southern Europe (7.61%) and lower in Northern Europe (4.68%). Low birth weight rates escalated about 20% in Southern Europe and to less extent in Easter Europe (7%) and Asian/Oceanian countries, while remained stable in America, Central Europe and Northern Europe. Investment in health care, private health system coverage, ratios of paediatricians and obstetricians, average length of admission due to pregnancy or birth and Caesarean section rate were associated with higher low birth weight rates. Factors associated with lower low birth weight rates were health care coverage, public health system coverage, hospitals per million inhabitants, and ratios of health care workers, physicians, midwives and nurses., Conclusions: In OECD countries, LBW rates are related to contextual country characteristics such as GDP per capita, which is inversely related to LBW rate. Health care system factors, including health care coverage or investment in public health system, are directly associated with lower LBW rates.

Published
2021
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