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  • EPV034/#116 Predicting the rate of adjuvant postoperative chemo/radiation of patients with the recently updated stage IB2 cervical cancer: an Israeli gynecologic oncology group study

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EPV034/#116 Predicting the rate of adjuvant postoperative chemo/radiation of patients with the recently updated stage IB2 cervical cancer: an Israeli gynecologic oncology group study
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  1. O Gemer1,
  2. A Namazov1,
  3. A Ben Arie2,
  4. R Eitan3,
  5. A Rabinovich4,
  6. Z Vaknin5,
  7. S Armon6,
  8. I Bruchim7,
  9. T Levy8,
  10. I Ben Shachar9 and
  11. O Lavie10
  1. 1Barzilai Medical Center, Gynecology, Ashkelon, Israel
  2. 2Kaplan Medical Center, Hebrew University, Gynecology, Rehovot, Israel
  3. 3Rabin Medical Center, Gynecology, Petah Tikva, Israel
  4. 4Soroka Medical Center, Gynecology, Beer Sheva, Israel
  5. 5Assaf Haroffe Medical Center, Sackler School of Medicine, Gynecology, Zrifin, Israel
  6. 6Shaare Zedek Medical Center, Hebrew University, Gynecology, Jerusalem, Israel
  7. 7Meir Medical Center, Sackler School of Medicine, Tel Aviv University, Gynecology, Kfar Saba, Israel
  8. 8Wolfson Medical Center, Holon, Sackler Faculty of Medicine, Tel Aviv University, Gynecology, Tel Aviv, Israel
  9. 9Hadassah Medical Center, Hebrew University, Gynecology, Jerusalem, Israel
  10. 10Carmel Medical Center, Obstetrics and Gynecology, Haifa, Israel

Abstract

Objectives Women with cervical cancer who undergo radical hysterectomy are often treated postoperatively with chemoradiation. The patient selection that minimizes adjuvant treatment is valuable. We compared two methods for predicting postoperative adjuvant treatment of patients with stage IB2 cervical cancer.

Methods This multicenter retrospective study included 272 women with IB2 tumors. A receiver operating characteristic curve (ROC) analysis was used to determine the optimal tumor cutoff size to predict adjuvant treatment. A second analysis compared the rate of adjuvant treatment between women with and without lymph vascular space involvement (LVSI).

Results According to the ROC, the optimal cutoff value of tumor size for predicting adjuvant treatment was 2.95 cm (sensitivity 0.70, specificity 0.67). Tumors were ≥3.0 cm in 166 (61.0%) women. The rate of adjuvant treatment was higher in women with larger tumor diameter (73.8% vs. 47.9%, p<0.0001). of the 241 women with a LVSI record, LVSI was present in 81 (34%) women. Among women with LVSI, rates were higher of positive lymph nodes (41.0% vs 14.5%, p<0.0001) and postoperative adjuvant treatment (83.3% vs. 53.7%, p<0.001). Among women with tumor size ≥3.0 cm and LVSI, the rate of adjuvant treatment was 90.0%. In the multivariate analysis, both tumor size ≥3.0 cm and the presence of LVSI were independently associated with adjuvant treatment (OR 3.9, 95% CI 2.1–7.1; p<0.0001 and OR 4.9, 95% CI 2.4–10.0; p<0.0001, respectively).

Conclusions These data should be weighed in multidisciplinary consultation with radiation oncologists when deciding treatment strategy.

https://doi.org/10.1136/ijgc-2021-IGCS.102

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