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Cervical cancer
2022-RA-827-ESGO Sentinel node biopsy diminishes de use of adjuvant therapy in women with early cervical cancer in the SUCCOR cohort
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  1. Arantxa Berasaluce Gómez1,
  2. Luis Chiva de Agustín2,
  3. Félix Boria Alegre2,
  4. Teresa Castellanos2,
  5. Daniel Vázquez Vicente2,
  6. Lidia Sancho Rodriguez3,
  7. Juan Luis Alcázar Zambrano4,
  8. Monica Gutiérrez Martínez2,
  9. Nabil Manzour Sifontes4,
  10. José Ángel Mínguez Milio4,
  11. Enrique María Chacón Cruz4 and
  12. Nerea Martín Calvo1
  1. 1Medicina Preventiva y Salud Pública, Universidad de Navarra, Pamplona, Spain
  2. 2Obstetrics and Gynecology, Clínica Universidad de Navarra, Madrid, Spain
  3. 3Nuclear Medicine, Clínica Universidad de Navarra, Madrid, Spain
  4. 4Obstetrics and Gynecology, Clínica Universidad de Navarra, Pamplona, Spain

Abstract

Introduction/Background The aim of the study was to compare the use of adjuvant therapy in women with stage IB1 cervical cancer depending on the method used to diagnose lymphatic node invasion.

Methodology We used data from the SUCCOR study, that collected information from 1049 women operated on stage IB1 cervical cancer between January 2013 and December 2014. Inverse probability weighting was used to adjust for surgical approach, use of uterine manipulator, lymphovascular space invasion, parametrial space invasion and conization, such that there were no significant differences between both groups. We calculated the adjusted proportion of women who received adjuvant therapy depending on the lymph node diagnosis method and compared disease free and overall survival using Cox regression.

Results The adjusted proportion of women who received adjuvant therapy was 33.8% in the sentinel node biopsy (SNB) group and 44.7% in the lymphadenectomy group (p=0.02), although the proportion of positive nodal status in both groups was similar (14% and 10.7% respectively. p=0.30). That difference was even greater in women with negative nodal status (adjusted difference 13.7%; p=0.002) and in the analysis restricted to women with negative nodal status and positive SEDLIS criteria (adjusted difference 31.2%; p=0.01). In this last group, women who underwent a SNB had an increased risk of relapse (HR: 2.50; 95%CI 0.98–6.33) and risk of death (HR: 3.5; 95% CI 1.04–11.7) compared to those who underwent lymphadenectomy.

View this table:
Abstract 2022-RA-827-ESGO Table 1

Proportion of women in the SUCCOR cohort that underwent adjuvant theraphy by method of lymph node diagnosis

Abstract 2022-RA-827-ESGO Figure 1
Abstract 2022-RA-827-ESGO Figure 1

Conclusion Women with the same clinical characteristics were less likely to receive adjuvant therapy if their nodal invasion was determined using SNB compared to lymphadenectomy. This difference was at the expense of women with negative nodal status but positive SEDLIS criteria. These results suggest a lack of therapeutic measures when a negative result is obtained by SNB, which may have an impact on the risk of recurrence and survival.

https://doi.org/10.1136/ijgc-2022-ESGO.63

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