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Cervical cancer
942 Survival after recurrence in early-stage cervical cancer patients
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  1. L Van Lonkhuijzen1,
  2. L Dostalek2,
  3. J Jarkovsky3,
  4. A Lopez4,
  5. H Falconer5,
  6. G Scambia6,
  7. A Ayhan7,
  8. S Kim8,
  9. D Isla Ortiz9,
  10. J Klat10,
  11. A Obermair11,
  12. GDI Martino12,
  13. R Pareja13,
  14. R Manchanda14,
  15. J Kostun15,
  16. R Dos Reis16,
  17. I Zapardiel17,
  18. V Weinberger18 and
  19. D Cibula2
  1. 1Amsterdam UMC, locatie AMC, Gynecologic oncology, Amsterdam, Netherlands
  2. 2First Faculty of Medicine Charles University, Gynecologic Oncology Center, Department of Obstetrics and Gynecology, Prague, Czech Republic
  3. 3Faculty of Medicine Masaryk University, Czech Republic
  4. 4National Institute of Neoplastic Diseases, Gynecological Surgery
  5. 5Karolinska University Hospital, Department of Pelvic Cancer, Stockholm, Sweden
  6. 6Fondazione Policlinico Universitario A. Gemelli, Roma, Italy
  7. 7Başkent University, Gynecology and Obstetrics, Division of Gynecologic Oncology, Ankara, Turkey
  8. 8Memorial Sloan Kettering Cancer Center, Department of Surgery, New York, USA
  9. 9National Institute of Cancerology Mexico, Gynecology Oncology Center, mexico, Mexico
  10. 10University of Ostrava – Faculty of Medicine, Obstetrics and Gynecology, Ostrava, Czech Republic
  11. 11The University of Queensland, Queensland Centre for Gynaecological Cancer, Saint Lucia, Australia
  12. 12Building U6 – University of Milano-Bicocca, Department of Obstetrics and Gynecology, Gynaecologic Oncology Surgical Unit, Milano, Italy
  13. 13National Cancer Institute – ESE, Department of Gynecologic Oncology, Bogotá, Colombia
  14. 14Queen Mary University of London, Barts Cancer Centre, UK
  15. 15University Hospital in Pilsen, Department of Gynaecology and Obstetrics, Prague, Czech Republic
  16. 16The University of Texas MD Anderson Cancer Center, Department of Gynecologic Oncology and Reproductive Medicine, Houston, USA
  17. 17La Paz University Hospital, Gynecologic Oncology Unit, Madrid, Spain
  18. 18Faculty of Medicine Masaryk University, Brno, Czech Republic

Abstract

Introduction/Background*Up to 26% of early-stage cervical cancer patients relapse after primary surgical treatment. However, little is known about the factors affecting prognosis following disease recurrence. Hence, the aim of this study was to evaluate post-recurrence disease-specific survival (PR-DSS) and to identify respective prognostic factors.

Methodology Data from 528 early-stage cervical cancer patients who relapsed after primary surgical treatment performed between 2007 and 2016 were obtained from the SCCAN study (Surveillance in Cervical CANcer). Parameters related both to primary disease and recurrence diagnosis were combined to develop a multivariable Cox proportional hazards model predicting PR-DSS.

Result(s)*Five-year PR-DSS reached 39.1% (95% confidence interval: 22.7% – 44.5%) with median disease-free survival between primary surgery and recurrence diagnosis (DFI1) of 1.5 years and median survival after recurrence of 2.5 years. Six variables significant in multivariable analysis were included in the PR-DSS prognostic model; two related to the primary disease characteristics: maximal diameter of the tumour and lymphovascular space invasion; and four related to the recurrence diagnosis: DFI1, age, presence of symptoms, and recurrence localization (table 1). C-statistics of the final model after 10-fold internal validation equalled 0.701 (95% CI: 0.675 – 0.727). Five risk groups significantly differing in prognosis were identified, with 5-year DSS after recurrence of 85.6%, 62.0%, 46.7, 19.7%, and 0% in the highest risk group (figure 1).

View this table:
Abstract 942 Table 1

Multivariable Cox regression model for prediction of disease-specific death after recurrence

Abstract 942 Figure 1
Abstract 942 Figure 1

Disease specific survival of all patients stratified by risk score (N=528). Time zero was set at date of recurrence diagnosis

Conclusion*We have developed the first robust model of disease-specific survival after recurrence stratifying relapsing cervical cancer patients according to their risk profile using six traditional prognostic markers. The strongest factor related to the length of post-recurrence survival was the largest size of the primary tumour, followed by the presence of symptoms at the time of diagnosis, which remained significant even after correction for lead-time bias.

https://doi.org/10.1136/ijgc-2021-ESGO.78

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