The annual recurrence risk model for tailored surveillance strategy in patients with cervical cancer

被引：35

作者：

Cibula, David ^{[1
,2
]}

Dostalek, Lukas ^{[1
,2
]}

Jarkovsky, Jiri ^{[3
]}

Mom, Constantijne H. ^{[4
]}

Lopez, Aldo ^{[5
]}

Falconer, Henrik ^{[6
,7
]}

Fagotti, Anna ^{[8
]}

Ayhan, Ali ^{[9
]}

Kim, Sarah H. ^{[10
]}

Ortiz, David Isla ^{[11
]}

Klat, Jaroslav ^{[12
,13
]}

Obermair, Andreas ^{[14
]}

Landoni, Fabio ^{[15
]}

Rodriguez, Juliana ^{[16
]}

Manchanda, Ranjit ^{[17
,18
]}

Kostun, Jan ^{[19
]}

dos Reis, Ricardo ^{[20
]}

Meydanli, Mehmet M. ^{[21
]}

Odetto, Diego ^{[22
]}

Laky, Rene ^{[23
]}

Zapardiel, Ignacio ^{[24
]}

Weinberger, Vit ^{[25
]}

Benesova, Klara ^{[3
]}

Borcinova, Martina ^{[1
,2
]}

Pari, Darwin ^{[5
]}

Salehi, Sahar ^{[6
,7
]}

Bizzarri, Nicolo ^{[8
]}

Akilli, Huseyin ^{[9
]}

Abu-Rustum, Nadeem R. ^{[10
]}

Salcedo-Hernandez, Rosa A. ^{[11
]}

Javurkova, Veronika ^{[12
,13
]}

Slama, Jiri ^{[1
,2
]}

van Lonkhuijzen, Luc R. C. W. ^{[4
]}

机构：

[1] Charles Univ Prague, Fac Med 1, Dept Obstet & Gynecol, Gynecol Oncol Ctr, Prague, Czech Republic

[2] Gen Univ Hosp, Cent & Eastern European Gynecol Oncol Grp CEEGOG, Prague, Czech Republic

[3] Masaryk Univ, Fac Med, Inst Biostat & Anal, Brno, Czech Republic

[4] Amsterdam Med Ctr, Amsterdam, Netherlands

[5] Natl Inst Neoplast Dis, Dept Gynecol Surg, Lima, Peru

[6] Karolinska Univ Hosp, Dept Pelv Canc, Stockholm, Sweden

[7] Karolinska Inst, Dept Womens & Childrens Hlth, Stockholm, Sweden

[8] Fdn Policlin Univ A Gemelli, IRCCS, UOC Ginecol Oncol, Dipartimento Salute Donna & Bambino Salute Pubbl, Rome, Italy

[9] Baskent Univ, Sch Med, Dept Gynecol & Obstet, Div Gynecol Oncol, Ankara, Turkey

[10] Mem Sloan Kettering Canc Ctr, 1275 York Ave, New York, NY 10021 USA

[11] Natl Inst Cancerol Mexico, Gynecol Oncol Ctr, Mexico City, DF, Mexico

[12] Univ Hosp, Fac Med, Dept Obstet & Gynecol, Ostrava, Czech Republic

[13] Univ Ostrava, Ostrava, Czech Republic

[14] Univ Queensland, Queensland Ctr Gynaecol Canc, Brisbane, Qld 4072, Australia

[15] Univ Milano Bicocca, ASST Monza San Gerardo Hosp, Dept Obstet & Gynecol, Gynaecol Oncol Surg Unit, Monza, Italy

[16] Inst Nacl Cancerol, Dept Gynecol Oncol, Bogota, Colombia

[17] Queen Mary Univ London, Barts Canc Ctr, Wolfson Inst Prevent Med, London, England

[18] Barts Hlth NHS Trust, London, England

[19] Charles Univ Prague, Univ Hosp Pilsen, Dept Obstet & Gynaecol, Prague, Czech Republic

[20] Univ Texas MD Anderson Canc Ctr, Dept Gynecol Oncol & Reprod Med, Houston, TX 77030 USA

[21] Univ Hlth Sci, Zekai Tahir Burak Womens Hlth & Res Hosp, Dept Gynecol Oncol, Ankara, Turkey

[22] Inst Univ Hosp Italiano, Hosp Italiano Buenos Aires, Dept Gynecol Oncol, Buenos Aires, DF, Argentina

[23] Med Univ Graz, Gynecol, Graz, Austria

[24] La Paz Univ Hosp IdiPAZ, Gynecol Oncol Unit, Madrid, Spain

[25] Masaryk Univ, Univ Hosp Brno, Fac Med, Brno, Czech Republic

来源：

EUROPEAN JOURNAL OF CANCER | 2021年 / 158卷

关键词：

Cervical cancer; Surveillance; Prognostic model; Annual recurrence risk; FOLLOW-UP PROCEDURES; PROGNOSTIC-FACTORS; GYNECOLOGICAL CANCER; RADICAL HYSTERECTOMY; WOMEN; PREDICTION; NOMOGRAM; SURVIVAL; PARAMETERS; DIAGNOSIS;

D O I：

10.1016/j.ejca.2021.09.008

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Purpose: Current guidelines for surveillance strategy in cervical cancer are rigid, recommending the same strategy for all survivors. The aim of this study was to develop a robust model allowing for individualised surveillance based on a patient's risk profile. Methods: Data of 4343 early-stage patients with cervical cancer treated between 2007 and 2016 were obtained from the international SCCAN (Surveillance in Cervical Cancer) consortium. The Cox proportional hazards model predicting disease-free survival (DFS) was developed and internally validated. The risk score, derived from regression coefficients of the model, stratified the cohort into significantly distinctive risk groups. On its basis, the annual recurrence risk model (ARRM) was calculated. Results: Five variables were included in the prognostic model: maximal pathologic tumour diameter; tumour histotype; grade; number of positive pelvic lymph nodes; and lymphovascular space invasion. Five risk groups significantly differing in prognosis were identified with a five-year DFS of 97.5%, 94.7%, 85.2% and 63.3% in increasing risk groups, whereas a two-year DFS in the highest risk group equalled 15.4%. Based on the ARRM, the annual recurrence risk in the lowest risk group was below 1% since the beginning of follow-up and declined below 1% at years three, four and >5 in the medium-risk groups. In the whole cohort, 26% of recurrences appeared at the first year of the follow-up, 48% by year two and 78% by year five. Conclusion: The ARRM represents a potent tool for tailoring the surveillance strategy in early-stage patients with cervical cancer based on the patient's risk status and respective annual recurrence risk. It can easily be used in routine clinical settings internationally. (c) 2021 Elsevier Ltd. All rights reserved.

引用

页码：111 / 122

页数：12

共 33 条

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