Introduction/Background*In addition to positive pelvic lymph nodes, parametrial extension, and positive surgical margins, a combination of intermediate risk factors (Sedlis criteria) have been identified as poor prognostic factors.1-7 In these patients, adjuvant therapy is recommended in most of the clinical guidelines. However, indications for adjuvant therapy may be different in some settings in the daily clinical practice.
The aim of this study was to analyze the patterns of adjuvant treatment after radical hysterectomy for early cervical cancer in a large European cohort.
Methodology The succor database was fulfilled in 2019 for the succor study 8, comprising a total of of 1272 patients who underwent radical hysterectomy for IB1 cervical cancer in Europe between 2013 and 2014. Patterns of adjuvant therapy were analyzed, and 3 cohorts of patients were stablished. Potential factors that may influence on the relapse risk in this cohort were previously analyzed.9
Result(s)*Five hundred ten patients (44.1%) received some type of adjuvant therapy after the intervention in this cohort. 390 patients (33.7%) received either standard external radiation or concurrent chemoradiotherapy. Standard external radiation and brachytherapy were the most frequently used modalities of adjuvant treatment (215 [18.6%] and 251 patients [21.6%], respectively), while concomitant chemoradiation was used in 174 (15.1%) of the cases. After excluding standard indications of adjuvant therapy (positive nodal status, positive surgical margins, parametrial infiltration or intermediate risk Sedlis criteria), we identified 144 patients that did not fulfill any of the classical criteria, representing 28.2% of the patients that received adjuvant therapy and 12.4% of the entire cohort. We compared the 3 groups: no adjuvant therapy (NAT), adjuvant therapy with classical criteria (ATW) and adjuvant therapy without fulfilling classical criteria (ATWO). Disease-free survival (DFS) at 4.5 years was 90.4% (89.2-91.6%), 85.2% (83.2-87.2%), and 91.7% (89.3-94.1%) respectively. No difference in DFS was observed after adjustment for previous conization, tumour size >2cm, and minimally invasive approach.
Conclusion*In this European cohort, a higher proportion of patients who received adjuvant treatment was observed in comparison with the literature in women with early cervical cancer after radical hysterectomy. However, no differences in DFS were observed between groups.
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