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

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

Author: 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., 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, and Alcazar J. L.
Abstract: Introduction Comprehensive updated information on cervical cancer surgical treatment in Europe is scarce. Objective To 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. Methods The 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. Results The mean age of the patients was 47.1 years (SD 10.8), with a mean body mass index of 25.4 kg/m 2 (SD 4.9). A total of 423 (36.6%) patients had a previous cone biopsy. Tumor size (clinical examination) <2 cm was observed in 667 (57.7%) patients. The most frequent histology type was squamous carcinoma (794 (68.7%) patients), and positive lymph nodes were found in 143 (12.4%) patients. A total of 633 (54.8%) patients were operated by open abdominal surgery. Intra-operative complications occurred in 108 (9.3%) patients, and post-operative complications during the first month occurred in 249 (21.5%) patients, with bladder dysfunction as the most frequent event (119 (10.3%) patients). Clavien-Dindo grade III or higher complication occurred in 56 (4.8%) patients. A total of 510 (44.1%) patients received adjuvant therapy. After a median follow-up of 58 months (range 0-84), the 5-year disease-free survival was 88.3%, and the overall survival was 94.9%. In our population, 10 of the 11 surgical-related quality indicators currently recommended by ESGO were fully fulfilled 5 years before its implementation. Conc
Published: 2021

7. 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, M.M. Tavares, M. Golub, D. Perrone, A.M. Poka, R. Zusterzeel, P.L.M. Aluloski, I. Goffin, F. Haidopoulos, D. Haller, H. Jach, R. Yezhova, I. Bernardino, M. Bharathan, R. Maenpaa, M.M. Sukhin, V. Feron, J.-G. Fruscio, R. Kukk, K. Ponce, J. Demirkiran, F. Vorgias, G. Povolotskaya, N. Coronado Martín, P.J. Marina, T. Zapardiel, I. Bizzarri, N. Gorostidi, M. Gutierrez, M. Manzour, N. Berasaluce, A. and 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.M. Tavares, M. Golub, D. Perrone, A.M. Poka, R. Zusterzeel, P.L.M. Aluloski, I. Goffin, F. Haidopoulos, D. Haller, H. Jach, R. Yezhova, I. Bernardino, M. Bharathan, R. Maenpaa, M.M. Sukhin, V. Feron, J.-G. Fruscio, R. Kukk, K. Ponce, J. Demirkiran, F. Vorgias, G. Povolotskaya, N. Coronado Martín, P.J. Marina, T. Zapardiel, I. Bizzarri, N. Gorostidi, M. Gutierrez, M. Manzour, N. Berasaluce, A.
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 t
Published: 2022

8. SUCCOR cone study: conization before radical hysterectomy

Author: Chacon, E., Manzour, N., Zanagnolo, V., Querleu, D., Núñez-Córdoba, J.M., Martin-Calvo, N., Căpîlna, M.E., Fagotti, A., Kucukmetin, A., Mom, C., Chakalova, G., Shamistan, A., Moreno, 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., Vujić, 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., Minguez, J.A., Vázquez-Vicente, D., Castellanos, T., Boria, F., Alcazar, J.L., Chiva, L., Chacon, E., Manzour, N., Zanagnolo, V., Querleu, D., Núñez-Córdoba, J.M., Martin-Calvo, N., Căpîlna, M.E., Fagotti, A., Kucukmetin, A., Mom, C., Chakalova, G., Shamistan, A., Moreno, 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., Vujić, 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., Minguez, J.A., Vázquez-Vicente, D., Castellanos, T., Boria, F., Alcazar, J.L., and Chiva, L.
Abstract: Item does not contain fulltext, 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 conizatio
Published: 2022

9. 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, M.M., Tavares, M., Golub, D., Perrone, A.M., Poka, R., Zusterzeel, P.L.M., Aluloski, I., Goffin, F., Haidopoulos, D., Haller, H., Jach, R., Yezhova, I., Bernardino, M., Bharathan, R., Maenpaa, M.M., Sukhin, V., Feron, J.G., Fruscio, R., Kukk, K., Ponce, J., Demirkiran, F., Vorgias, G., Povolotskaya, N., Martín, P.J. Coronado, Marina, T., Zapardiel, I., Bizzarri, N., Gorostidi, M., Gutierrez, M., Manzour, N., Berasaluce, A., Martin-Calvo, N., 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.M., Tavares, M., Golub, D., Perrone, A.M., Poka, R., Zusterzeel, P.L.M., Aluloski, I., Goffin, F., Haidopoulos, D., Haller, H., Jach, R., Yezhova, I., Bernardino, M., Bharathan, R., Maenpaa, M.M., Sukhin, V., Feron, J.G., Fruscio, R., Kukk, K., Ponce, J., Demirkiran, F., Vorgias, G., Povolotskaya, N., Martín, P.J. Coronado, Marina, T., Zapardiel, I., Bizzarri, N., Gorostidi, M., Gutierrez, M., Manzour, N., Berasaluce, A., and Martin-Calvo, N.
Abstract: Item does not contain fulltext, 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 ther
Published: 2022

10. 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

11. SUCCOR cone study: conization before radical hysterectomy

Author: 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, Chiva, L, Chacon, Enrique, Manzour, Nabil, Zanagnolo, Vanna, Querleu, Denis, Núñez-Córdoba, Jorge M, Martin-Calvo, Nerea, Căpîlna, Mihai Emil, Fagotti, Anna, Kucukmetin, Ali, Mom, Constantijne, Chakalova, Galina, Shamistan, Aliyev, Gil Moreno, Antonio, Malzoni, Mario, Narducci, Fabrice, Arencibia, Octavio, Raspagliesi, Francesco, Toptas, Tayfun, Cibula, David, Kaidarova, Dilyara, Meydanli, Mehmet Mutlu, Tavares, Mariana, Golub, Dmytro, Perrone, Anna Myriam, Poka, Robert, Tsolakidis, Dimitrios, Vujić, Goran, Jedryka, Marcin A, Zusterzeel, Petra L M, Beltman, Jogchum Jan, Goffin, Frederic, Haidopoulos, Dimitrios, Haller, Herman, Jach, Robert, Yezhova, Iryna, Berlev, Igor, Bernardino, Margarida, Bharathan, Rasiah, Lanner, Maximilian, Maenpaa, Minna M, Sukhin, Vladyslav, Feron, Jean-Guillaume, Fruscio, Robert, Kukk, Kersti, Ponce, Jordi, Minguez, Jose Angel, Vázquez-Vicente, Daniel, Castellanos, Teresa, Boria, Felix, Alcazar, Juan Luis, Chiva, Luis, 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, Chiva, L, Chacon, Enrique, Manzour, Nabil, Zanagnolo, Vanna, Querleu, Denis, Núñez-Córdoba, Jorge M, Martin-Calvo, Nerea, Căpîlna, Mihai Emil, Fagotti, Anna, Kucukmetin, Ali, Mom, Constantijne, Chakalova, Galina, Shamistan, Aliyev, Gil Moreno, Antonio, Malzoni, Mario, Narducci, Fabrice, Arencibia, Octavio, Raspagliesi, Francesco, Toptas, Tayfun, Cibula, David, Kaidarova, Dilyara, Meydanli, Mehmet Mutlu, Tavares, Mariana, Golub, Dmytro, Perrone, Anna Myriam, Poka, Robert, Tsolakidis, Dimitrios, Vujić, Goran, Jedryka, Marcin A, Zusterzeel, Petra L M, Beltman, Jogchum Jan, Goffin, Frederic, Haidopoulos, Dimitrios, Haller, Herman, Jach, Robert, Yezhova, Iryna, Berlev, Igor, Bernardino, Margarida, Bharathan, Rasiah, Lanner, Maximilian, Maenpaa, Minna M, Sukhin, Vladyslav, Feron, Jean-Guillaume, Fruscio, Robert, Kukk, Kersti, Ponce, Jordi, Minguez, Jose Angel, Vázquez-Vicente, Daniel, Castellanos, Teresa, Boria, Felix, Alcazar, Juan Luis, and Chiva, Luis
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 conizatio
Published: 2022

12. Radical hysterectomy in early cervical cancer in Europe: characteristics, outcomes and evaluation of ESGO quality indicators

Author: Boria, F., Chiva, L., Zanagnolo, V., Querleu, D., Martin-Calvo, N., Căpîlna, 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., Vujić, 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-Espías, M., Minguez, J.A., Vázquez-Vicente, D., Manzour, N., Jurado, M., Castellanos, T., Chacon, E., Alcazar, J.L., Boria, F., Chiva, L., Zanagnolo, V., Querleu, D., Martin-Calvo, N., Căpîlna, 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., Vujić, 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-Espías, M., Minguez, J.A., Vázquez-Vicente, D., Manzour, N., Jurado, M., Castellanos, T., Chacon, E., and Alcazar, J.L.
Abstract: Item does not contain fulltext, INTRODUCTION: Comprehensive updated information on cervical cancer surgical treatment in Europe is scarce. OBJECTIVE: To 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. METHODS: The 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. RESULTS: The mean age of the patients was 47.1 years (SD 10.8), with a mean body mass index of 25.4 kg/m(2) (SD 4.9). A total of 423 (36.6%) patients had a previous cone biopsy. Tumor size (clinical examination) <2 cm was observed in 667 (57.7%) patients. The most frequent histology type was squamous carcinoma (794 (68.7%) patients), and positive lymph nodes were found in 143 (12.4%) patients. A total of 633 (54.8%) patients were operated by open abdominal surgery. Intra-operative complications occurred in 108 (9.3%) patients, and post-operative complications during the first month occurred in 249 (21.5%) patients, with bladder dysfunction as the most frequent event (119 (10.3%) patients). Clavien-Dindo grade III or higher complication occurred in 56 (4.8%) patients. A total of 510 (44.1%) patients received adjuvant therapy. After a median follow-up of 58 months (range 0-84), the 5-year disease-free survival was 88.3%, and the overall survival was 94.9%. In our population, 10 of the 11 surgical-related quality indicators currently recommended by ESGO were fully fulfilled 5 years before its implementation. CO
Published: 2021

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

Author: Boria F., Chiva L., Zanagnolo V., Querleu D., Martin-Calvo N., CA Pilna M. E., 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., Fagotti, Anna, Fagotti A. (ORCID:0000-0001-5579-335X), Boria F., Chiva L., Zanagnolo V., Querleu D., Martin-Calvo N., CA Pilna M. E., 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., Fagotti, Anna, and Fagotti A. (ORCID:0000-0001-5579-335X)
Abstract: Introduction Comprehensive updated information on cervical cancer surgical treatment in Europe is scarce. Objective To 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. Methods The 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. Results The mean age of the patients was 47.1 years (SD 10.8), with a mean body mass index of 25.4 kg/m 2 (SD 4.9). A total of 423 (36.6%) patients had a previous cone biopsy. Tumor size (clinical examination) <2 cm was observed in 667 (57.7%) patients. The most frequent histology type was squamous carcinoma (794 (68.7%) patients), and positive lymph nodes were found in 143 (12.4%) patients. A total of 633 (54.8%) patients were operated by open abdominal surgery. Intra-operative complications occurred in 108 (9.3%) patients, and post-operative complications during the first month occurred in 249 (21.5%) patients, with bladder dysfunction as the most frequent event (119 (10.3%) patients). Clavien-Dindo grade III or higher complication occurred in 56 (4.8%) patients. A total of 510 (44.1%) patients received adjuvant therapy. After a median follow-up of 58 months (range 0-84), the 5-year disease-free survival was 88.3%, and the overall survival was 94.9%. In our population, 10 of the 11 surgical-related quality indicators currently recommended by ESGO were fully fulfilled 5 years before its implementation. Conc
Published: 2021

14. SUCCOR study: An international European cohort observational study comparing minimally invasive surgery versus open abdominal radical hysterectomy in patients with stage IB1 cervical cancer

Author: Chiva, L. Zanagnolo, V. Querleu, D. Martin-Calvo, N. Arévalo-Serrano, J. Cǎpîlna, M.E. 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.M. Tavares, M. Golub, D. Perrone, A.M. Poka, R. Tsolakidis, D. Vujić, 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. Minguez, J.A. Vázquez-Vicente, D. Castellanos, T. Chacon, E. Alcazar, J.L. On behalf of the SUCCOR study Group
Abstract: Background Minimally invasive surgery in cervical cancer has demonstrated in recent publications worse outcomes than open surgery. The primary objective of the SUCCOR study, a European, multicenter, retrospective, observational cohort study was to evaluate disease-free survival in patients with stage IB1 (FIGO 2009) cervical cancer undergoing open vs minimally invasive radical hysterectomy. As a secondary objective, we aimed to investigate the association between protective surgical maneuvers and the risk of relapse. Methods We obtained data from 1272 patients that underwent a radical hysterectomy by open or minimally invasive surgery for stage IB1 cervical cancer (FIGO 2009) from January 2013 to December 2014. After applying all the inclusion-exclusion criteria, we used an inverse probability weighting to construct a weighted cohort of 693 patients to compare outcomes (minimally invasive surgery vs open). The first endpoint compared disease-free survival at 4.5 years in both groups. Secondary endpoints compared overall survival among groups and the impact of the use of a uterine manipulator and protective closure of the colpotomy over the tumor in the minimally invasive surgery group. Results Mean age was 48.3 years (range; 23-83) while the mean BMI was 25.7 kg/m 2 (range; 15-49). The risk of recurrence for patients who underwent minimally invasive surgery was twice as high as that in the open surgery group (HR, 2.07; 95% CI, 1.35 to 3.15; P=0.001). Similarly, the risk of death was 2.42-times higher than in the open surgery group (HR, 2.45; 95% CI, 1.30 to 4.60, P=0.005). Patients that underwent minimally invasive surgery using a uterine manipulator had a 2.76-times higher hazard of relapse (HR, 2.76; 95% CI, 1.75 to 4.33; P
Published: 2020

15. SUCCOR study: an international European cohort observational study comparing minimally invasive surgery versus open abdominal radical hysterectomy in patients with stage IB1 cervical cancer

Author: Chiva, L., Zanagnolo, V., Querleu, D., Martin-Calvo, N., Arévalo-Serrano, J., Căpîlna, M.E., 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.M., Tavares, M., Golub, D., Perrone, A.M., Poka, R., Tsolakidis, D., Vujić, 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., Minguez, J.A., Vázquez-Vicente, D., Castellanos, T., Chacon, E., Alcazar, J.L., Chiva, L., Zanagnolo, V., Querleu, D., Martin-Calvo, N., Arévalo-Serrano, J., Căpîlna, M.E., 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.M., Tavares, M., Golub, D., Perrone, A.M., Poka, R., Tsolakidis, D., Vujić, 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., Minguez, J.A., Vázquez-Vicente, D., Castellanos, T., Chacon, E., and Alcazar, J.L.
Abstract: Contains fulltext : 225380.pdf (Publisher’s version ) (Closed access), BACKGROUND: Minimally invasive surgery in cervical cancer has demonstrated in recent publications worse outcomes than open surgery. The primary objective of the SUCCOR study, a European, multicenter, retrospective, observational cohort study was to evaluate disease-free survival in patients with stage IB1 (FIGO 2009) cervical cancer undergoing open vs minimally invasive radical hysterectomy. As a secondary objective, we aimed to investigate the association between protective surgical maneuvers and the risk of relapse. METHODS: We obtained data from 1272 patients that underwent a radical hysterectomy by open or minimally invasive surgery for stage IB1 cervical cancer (FIGO 2009) from January 2013 to December 2014. After applying all the inclusion-exclusion criteria, we used an inverse probability weighting to construct a weighted cohort of 693 patients to compare outcomes (minimally invasive surgery vs open). The first endpoint compared disease-free survival at 4.5 years in both groups. Secondary endpoints compared overall survival among groups and the impact of the use of a uterine manipulator and protective closure of the colpotomy over the tumor in the minimally invasive surgery group. RESULTS: Mean age was 48.3 years (range; 23-83) while the mean BMI was 25.7 kg/m(2) (range; 15-49). The risk of recurrence for patients who underwent minimally invasive surgery was twice as high as that in the open surgery group (HR, 2.07; 95% CI, 1.35 to 3.15; P=0.001). Similarly, the risk of death was 2.42-times higher than in the open surgery group (HR, 2.45; 95% CI, 1.30 to 4.60, P=0.005). Patients that underwent minimally invasive surgery using a uterine manipulator had a 2.76-times higher hazard of relapse (HR, 2.76; 95% CI, 1.75 to 4.33; P<0.001) and those without the use of a uterine manipulator had similar disease-free-survival to the open surgery group (HR, 1.58; 95% CI, 0.79 to 3.15; P=0.20). Moreover, patients that underwent minimally invasive surgery with protective vag
Published: 2020

16. SUCCOR study: an international European cohort observational study comparing minimally invasive surgery versus open abdominal radical hysterectomy in patients with stage IB1 cervical cancer

Author: Chiva, L, Zanagnolo, V, Querleu, D, Martin-Calvo, N, Arévalo-Serrano, J, Căpîlna, 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, 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, Chacon, E, Alcazar, J, Chiva, Luis, Zanagnolo, Vanna, Querleu, Denis, Martin-Calvo, Nerea, Arévalo-Serrano, Juan, Căpîlna, Mihai Emil, Fagotti, Anna, Kucukmetin, Ali, Mom, Constantijne, Chakalova, Galina, Aliyev, Shamistan, Malzoni, Mario, Narducci, Fabrice, Arencibia, Octavio, Raspagliesi, Francesco, Toptas, Tayfun, Cibula, David, Kaidarova, Dilyara, Meydanli, Mehmet Mutlu, Tavares, Mariana, Golub, Dmytro, Perrone, Anna Myriam, Poka, Robert, Tsolakidis, Dimitrios, Vujić, Goran, Jedryka, Marcin A, Zusterzeel, Petra L M, Beltman, Jogchum Jan, Goffin, Frederic, Haidopoulos, Dimitrios, Haller, Herman, Jach, Robert, Yezhova, Iryna, Berlev, Igor, Bernardino, Margarida, Bharathan, Rasiah, Lanner, Maximilian, Maenpaa, Minna M, Sukhin, Vladyslav, Feron, Jean-Guillaume, Fruscio, Robert, Kukk, Kersti, Ponce, Jordi, Minguez, Jose Angel, Vázquez-Vicente, Daniel, Castellanos, Teresa, Chacon, Enrique, Alcazar, Juan Luis, Chiva, L, Zanagnolo, V, Querleu, D, Martin-Calvo, N, Arévalo-Serrano, J, Căpîlna, 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, 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, Chacon, E, Alcazar, J, Chiva, Luis, Zanagnolo, Vanna, Querleu, Denis, Martin-Calvo, Nerea, Arévalo-Serrano, Juan, Căpîlna, Mihai Emil, Fagotti, Anna, Kucukmetin, Ali, Mom, Constantijne, Chakalova, Galina, Aliyev, Shamistan, Malzoni, Mario, Narducci, Fabrice, Arencibia, Octavio, Raspagliesi, Francesco, Toptas, Tayfun, Cibula, David, Kaidarova, Dilyara, Meydanli, Mehmet Mutlu, Tavares, Mariana, Golub, Dmytro, Perrone, Anna Myriam, Poka, Robert, Tsolakidis, Dimitrios, Vujić, Goran, Jedryka, Marcin A, Zusterzeel, Petra L M, Beltman, Jogchum Jan, Goffin, Frederic, Haidopoulos, Dimitrios, Haller, Herman, Jach, Robert, Yezhova, Iryna, Berlev, Igor, Bernardino, Margarida, Bharathan, Rasiah, Lanner, Maximilian, Maenpaa, Minna M, Sukhin, Vladyslav, Feron, Jean-Guillaume, Fruscio, Robert, Kukk, Kersti, Ponce, Jordi, Minguez, Jose Angel, Vázquez-Vicente, Daniel, Castellanos, Teresa, Chacon, Enrique, and Alcazar, Juan Luis
Abstract: Background: Minimally invasive surgery in cervical cancer has demonstrated in recent publications worse outcomes than open surgery. The primary objective of the SUCCOR study, a European, multicenter, retrospective, observational cohort study was to evaluate disease-free survival in patients with stage IB1 (FIGO 2009) cervical cancer undergoing open vs minimally invasive radical hysterectomy. As a secondary objective, we aimed to investigate the association between protective surgical maneuvers and the risk of relapse. Methods: We obtained data from 1272 patients that underwent a radical hysterectomy by open or minimally invasive surgery for stage IB1 cervical cancer (FIGO 2009) from January 2013 to December 2014. After applying all the inclusion-exclusion criteria, we used an inverse probability weighting to construct a weighted cohort of 693 patients to compare outcomes (minimally invasive surgery vs open). The first endpoint compared disease-free survival at 4.5 years in both groups. Secondary endpoints compared overall survival among groups and the impact of the use of a uterine manipulator and protective closure of the colpotomy over the tumor in the minimally invasive surgery group. Results: Mean age was 48.3 years (range; 23-83) while the mean BMI was 25.7 kg/m2 (range; 15-49). The risk of recurrence for patients who underwent minimally invasive surgery was twice as high as that in the open surgery group (HR, 2.07; 95% CI, 1.35 to 3.15; P=0.001). Similarly, the risk of death was 2.42-times higher than in the open surgery group (HR, 2.45; 95% CI, 1.30 to 4.60, P=0.005). Patients that underwent minimally invasive surgery using a uterine manipulator had a 2.76-times higher hazard of relapse (HR, 2.76; 95% CI, 1.75 to 4.33; P<0.001) and those without the use of a uterine manipulator had similar disease-free-survival to the open surgery group (HR, 1.58; 95% CI, 0.79 to 3.15; P=0.20). Moreover, patients that underwent minimally invasive surgery with protective va
Published: 2020

17. 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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18. SUCCOR study: an international European cohort observational study comparing minimally invasive surgery versus open abdominal radical hysterectomy in patients with stage IB1 cervical cancer

Author: Chiva, Luis, Zanagnolo, Vanna, Querleu, Denis, Martin-Calvo, Nerea, Arévalo-Serrano, Juan, Căpîlna, Mihai Emil, Fagotti, Anna, Kucukmetin, Ali, Mom, Constantijne, Chakalova, Galina, Aliyev, Shamistan, Malzoni, Mario, Narducci, Fabrice, Arencibia, Octavio, Raspagliesi, Francesco, Toptas, Tayfun, Cibula, David, Kaidarova, Dilyara, Meydanli, Mehmet Mutlu, Tavares, Mariana, Golub, Dmytro, Perrone, Anna Myriam, Poka, Robert, Tsolakidis, Dimitrios, Vujić, Goran, Jedryka, Marcin A, Zusterzeel, Petra L M, Beltman, Jogchum Jan, Goffin, Frederic, Haidopoulos, Dimitrios, Haller, Herman, Jach, Robert, Yezhova, Iryna, Berlev, Igor, Bernardino, Margarida, Bharathan, Rasiah, Lanner, Maximilian, Maenpaa, Minna M, Sukhin, Vladyslav, Feron, Jean-Guillaume, Fruscio, Robert, Kukk, Kersti, Ponce, Jordi, Minguez, Jose Angel, Vázquez-Vicente, Daniel, Castellanos, Teresa, Chacon, Enrique, Alcazar, Juan, Luis, Nabil, Abdalla, Özgür, Akbayir, Sedat, Akgöl, Elif, Aksahin, Shamistan, Aliyev, Maria, Alonso-Espias, Igor, Aluloski, Claudia, Andrade, Nikola, Badzakov, Rosa, Barrachina, Giorgio, Bogani, Eduard-Aexandru, Bonci, Hélène, Bonsang-Kitzis, Felix, Boria, 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, Annamaria, Ferrero, 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, Nabil, Manzour, 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, Obstetrics and gynaecology, CCA - Cancer biology and immunology, CCA - Cancer Treatment and quality of life, Amsterdam Reproduction & Development (AR&D), Ethics, Law & Medical humanities, Chiva L., Zanagnolo V., Querleu D., Martin-Calvo N., Arevalo-Serrano J., Capilna M.E., 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.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., Minguez J.A., Vazquez-Vicente D., Castellanos T., Chacon E., Alcazar J.L., Chiva, L, Zanagnolo, V, Querleu, D, Martin-Calvo, N, Arévalo-Serrano, J, Căpîlna, 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, 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, Chacon, E, Alcazar, J, INSERM, Université de Lille, Protéomique, Réponse Inflammatoire, Spectrométrie de Masse (PRISM) - U1192, Clínica Universidad de Navarra [Pamplona], Istituto Europeo di Oncologia [Milano] [IEO], Institut Bergonié [Bordeaux], Universidad de Navarra [Pamplona] [UNAV], Istituto Europeo di Oncologia [Milano] (IEO), UNICANCER, Universidad de Navarra [Pamplona] (UNAV), Protéomique, Réponse Inflammatoire, Spectrométrie de Masse (PRISM) - U 1192 (PRISM), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)
Subjects: Adult, BIOMEDICINE AND HEALTHCARE. Clinical Medical Sciences, medicine.medical_specialty, Uterine Cervical Neoplasm, cervical cancer, [SDV]Life Sciences [q-bio], 03 medical and health sciences, Young Adult, surgical oncology, 0302 clinical medicine, hysterectomy, laparoscope, cervix uteri, laparotomy, Surgical oncology, local, medicine, Radical Hysterectomy, Prospective cohort study, Cancer staging, Aged, Neoplasm Staging, Cervical cancer, Aged, 80 and over, 030219 obstetrics & reproductive medicine, neoplasm recurrence, local, business.industry, BIOMEDICINA I ZDRAVSTVO. Kliničke medicinske znanosti, Obstetrics and Gynecology, Retrospective cohort study, Minimally Invasive Surgical Procedure, Middle Aged, medicine.disease, neoplasm recurrence, Surgery, Women's cancers Radboud Institute for Health Sciences [Radboudumc 17], Europe, Settore MED/40 - GINECOLOGIA E OSTETRICIA, laparoscopes, Oncology, 030220 oncology & carcinogenesis, Cohort, Female, Cohort Studie, business, Cohort study, Human
Abstract: SUCCOR study: an international European cohort observational study comparing minimally invasive surgery versus open abdominal radical hysterectomy in patients with stage IB1 cervical cancer FREE http://orcid.org/0000-0002-1908-3251Luis Chiva1, Vanna Zanagnolo2, Denis Querleu3, Nerea Martin- Calvo4, Juan Arévalo-Serrano5, Mihai Emil Căpîlna6, Anna Fagotti7, Ali Kucukmetin8, Constantijne Mom9, Galina Chakalova10, Shamistan Aliyev11, Mario Malzoni12, http://orcid.org/0000- 0001-5809-3535Fabrice Narducci13, Octavio Arencibia14, Francesco Raspagliesi15, Tayfun Toptas16, David Cibula17, Dilyara Kaidarova18, http://orcid.org/0000-0001-6763-9720Mehmet Mutlu Meydanli19, Mariana Tavares20, Dmytro Golub21, http://orcid.org/0000-0003-3140-4772Anna Myriam Perrone22, Robert Poka23, Dimitrios Tsolakidis24, Goran Vujić25, http://orcid.org/0000-0001-8935- 0311Marcin A Jedryka26, Petra L M Zusterzeel27, Jogchum Jan Beltman28, Frederic Goffin29, Dimitrios Haidopoulos30, Herman Haller31, Robert Jach32, Iryna Yezhova33, Igor Berlev34, Margarida Bernardino35, Rasiah Bharathan36, Maximilian Lanner37, Minna M Maenpaa38, http://orcid.org/0000-0002-4403-3707Vladyslav Sukhin39, Jean-Guillaume Feron40, Robert Fruscio41, 42, Kersti Kukk43, Jordi Ponce44, Jose Angel Minguez45, http://orcid.org/0000-0002-9618- 5606Daniel Vázquez-Vicente45, Teresa Castellanos45, Enrique Chacon46 and http://orcid.org/0000-0002-9700-0853Juan Luis Alcazar47 On behalf of the SUCCOR study Group Author affiliations Abstract Background Minimally invasive surgery in cervical cancer has demonstrated in recent publications worse outcomes than open surgery. The primary objective of the SUCCOR study, a European, multicenter, retrospective, observational cohort study was to evaluate disease-free survival in patients with stage IB1 (FIGO 2009) cervical cancer undergoing open vs minimally invasive radical hysterectomy. As a secondary objective, we aimed to investigate the association between protective surgical maneuvers and the risk of relapse. Methods We obtained data from 1272 patients that underwent a radical hysterectomy by open or minimally invasive surgery for stage IB1 cervical cancer (FIGO 2009) from January 2013 to December 2014. After applying all the inclusion-exclusion criteria, we used an inverse probability weighting to construct a weighted cohort of 693 patients to compare outcomes (minimally invasive surgery vs open). The first endpoint compared disease-free survival at 4.5 years in both groups. Secondary endpoints compared overall survival among groups and the impact of the use of a uterine manipulator and protective closure of the colpotomy over the tumor in the minimally invasive surgery group. Results Mean age was 48.3 years (range ; 23–83) while the mean BMI was 25.7 kg/m2 (range ; 15–49). The risk of recurrence for patients who underwent minimally invasive surgery was twice as high as that in the open surgery group (HR, 2.07 ; 95% CI, 1.35 to 3.15 ; P=0.001). Similarly, the risk of death was 2.42-times higher than in the open surgery group (HR, 2.45 ; 95% CI, 1.30 to 4.60, P=0.005). Patients that underwent minimally invasive surgery using a uterine manipulator had a 2.76-times higher hazard of relapse (HR, 2.76 ; 95% CI, 1.75 to 4.33 ; P
Published: 2020
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19. 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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20. 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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21. 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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21 results on '"Yezhova, I"'

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

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

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

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

5. SUCCOR cone study

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

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

8. SUCCOR cone study: conization before radical hysterectomy

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

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

11. SUCCOR cone study: conization before radical hysterectomy

12. Radical hysterectomy in early cervical cancer in Europe: characteristics, outcomes and evaluation of ESGO quality indicators

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

14. SUCCOR study: An international European cohort observational study comparing minimally invasive surgery versus open abdominal radical hysterectomy in patients with stage IB1 cervical cancer

15. SUCCOR study: an international European cohort observational study comparing minimally invasive surgery versus open abdominal radical hysterectomy in patients with stage IB1 cervical cancer

16. SUCCOR study: an international European cohort observational study comparing minimally invasive surgery versus open abdominal radical hysterectomy in patients with stage IB1 cervical cancer

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

18. SUCCOR study: an international European cohort observational study comparing minimally invasive surgery versus open abdominal radical hysterectomy in patients with stage IB1 cervical cancer

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

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

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

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