Significance of histology and nodal status on the survival of women with early-stage cervical cancer: validation of the 2018 FIGO cervical cancer staging system

被引：1

作者：

Machida, Hiroko ^{[1
]}

Matsuo, Koji ^{[2
,3
]}

Kobayashi, Yoichi ^{[4
]}

Momomura, Mai ^{[4
]}

Takahashi, Fumiaki ^{[5
]}

Tabata, Tsutomu ^{[6
]}

Kondo, Eiji ^{[7
]}

Yamagami, Wataru ^{[8
]}

Ebina, Yasuhiko ^{[9
]}

Kaneuchi, Masanori ^{[10
]}

Nagase, Satoru ^{[11
]}

Mikami, Mikio ^{[1
]}

机构：

[1] Tokai Univ, Dept Obstet & Gynecol, Sch Med, Isehara, Kanagawa, Japan

[2] Univ Southern Calif, Div Gynecol Oncol, Dept Obstet & Gynecol, Los Angeles, CA 90007 USA

[3] Univ Southern Calif, Norris Comprehens Canc Ctr, Los Angeles, CA 90007 USA

[4] Kyorin Univ, Dept Obstet & Gynecol, Tokyo, Japan

[5] Iwate Med Univ, Dept Informat Sci, Div Med Engn, Morioka, Iwate, Japan

[6] Tokyo Womens Med Univ, Dept Obstet & Gynecol, Tokyo, Japan

[7] Mie Univ, Dept Obstet & Gynecol, Tsu, Mie, Japan

[8] Keio Univ, Dept Obstet & Gynecol, Sch Med, Tokyo, Japan

[9] Hokkaido Univ, Fac Hlth Sci, Sapporo, Hokkaido, Japan

[10] Otaru Gen Hosp, Dept Obstet & Gynecol, Otaru, Hokkaido, Japan

[11] Yamagata Univ, Dept Obstet & Gynecol, Yamagata, Japan

来源：

JOURNAL OF GYNECOLOGIC ONCOLOGY | 2022年 / 33卷 / 03期

关键词：

Uterine Cervical Neoplasms; Neoplasm Staging; Histological Type of Neoplasm; Lymph Node Metastasis; Survival; PELVIC RADIATION-THERAPY; RADICAL HYSTERECTOMY; HIGH-RISK; ADJUVANT CHEMOTHERAPY; LYMPHADENECTOMY; METASTASIS; CARCINOMA; HEALTH; JAPAN; IIA;

D O I：

10.3802/jgo.2022.33.e26

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Objective: To assess the efficacy of the FIGO 2018 classification system for nodal-specific classifications for early-stage cervical cancer; specifically, to examine the impact of nodal metastasis on survival and the effect of postoperative treatments, according to histological subtypes. Methods: This society-based retrospective observational study in Japan examined 16,539 women with the 2009 FIGO stage IB1 cervical cancer who underwent primary surgical treatment from 2004 to 2015. Associations of cause-specific survival (CSS) with nodal metastasis and postoperative adjuvant therapy were examined according to histology type (squamous cell carcinoma [SCC], n=10,315; and non-SCC, n=6,224). Results: The nodal metastasis rate for SCC was higher than that for non-SCC (10.7% vs. 8.3%, p<0.001). In multivariable analysis, the impact of nodal metastasis on CSS was greater for non-SCC tumors (adjusted-hazard ratio [HR], 3.11; 95% confidence interval [CI], 2.40- 4.02) than for SCC tumors (adjusted-HR, 2.20; 95% CI, 1.70-2.84; p<0.001). Propensity score matching analysis showed significantly lower CSS rates for women with pelvic nodal metastasis from non-SCC tumors than from SCC tumors (5-year CSS rate, 75.4% vs. 90.3%, p<0.001).The CSS rates for women with nodal metastasis in SCC histology were similar between the postoperative concurrent chemoradiotherapy/radiotherapy and chemotherapy groups (89.2% vs. 86.1%, p=0.42), whereas those in non-SCC histology who received postoperative chemotherapy improved the CSS (74.1% vs. 67.7%, p=0.043). Conclusion: The node-specific staging system in the 2018 FIGO cervical cancer classification is applicable to both non-SCC tumors and SCC tumors; however, the prognostic significance of nodal metastases and efficacy of postoperative therapies vary according to histology.

引用

页数：15