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#1119 Survival associated with extent of radical hysterectomy in early-stage cervical cancer: a sub-analysis of the SCCAN collaborative study
  1. Nicolò Bizzarri1,
  2. Denis Querleu1,
  3. Lukas Dostalek2,
  4. Luc Rcw Van Lonkhuijzen3,
  5. Diana Giannarelli4,
  6. Aldo Lopez5,
  7. Sahar Salehi6,
  8. Ali Ayhan7,
  9. Sarah K Kim8,
  10. David Isla Ortiz9,
  11. Jaroslav Klat10,
  12. Fabio Landoni11,
  13. Rene Pareja12,
  14. Ranjit Manchanda13,
  15. Jan Kostun14,
  16. Pedro T Ramirez15,
  17. Mehmet M Meydanli16,
  18. Diego Odetto17,
  19. Rene Laky18,
  20. Ignacio Zapardiel19,
  21. Vit Weinberger20,
  22. Ricardo Dos Reis21,
  23. Luigi Pedone Anchora1,
  24. Karina Amaro22,
  25. Huseyin Akilli7,
  26. Nadeem R Abu-Rustum8,
  27. Rosa A Salcedo-Hernandez9,
  28. Veronica Javurkova23,
  29. Constantijne H Mom3,
  30. Giovanni Scambia1,
  31. Henrik Falconer6 and
  32. David Cibula2
  1. 1UOC Ginecologia Oncologica, Dipartimento per la Salute della Donna e del Bambino e della Salute Pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
  2. 2Gynecologic Oncology Center, Department of Obstetrics and Gynecology, First Faculty of Medicine, Charles University and General University Hospital (Central and Eastern European Gynecologic Oncology Group, CEEGOG), Prague, Czech Republic
  3. 3Center for Gynaecologic Oncology Amsterdam, Amsterdam University Medical Centers, Amsterdam, The Netherlands
  4. 4Biostatistics Unit, Scientific Directorate, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
  5. 5Department of Gynecological Surgery, National Institute of Neoplastic Diseases, Lima, Peru
  6. 6Department of Pelvic Cancer, Karolinska University Hospital and Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
  7. 7Baskent University School of Medicine, Department of Gynecology and Obstetrics, Division of Gynecologic Oncology, Ankara, Türkiye
  8. 8Memorial Sloan Kettering Cancer Center, New York, USA
  9. 9Gynecology Oncology Center, National Institute of Cancerology Mexico, Mexico City, Mexico
  10. 10Department of Obstetrics and Gynecology, Faculty of Medicine, University Hospital and University of Ostrava, Ostrava, Czech Republic
  11. 11IRCCS Fondazione San Gerardo – Università Milano Bicocca, Monza, Italy
  12. 12Department of Gynecologic Oncology, Instituto Nacional de Cancerología, Bogotà, Colombia
  13. 13Wolfson Institute of Population Health, Barts Cancer Centre, Queen Mary University of London, and Barts Health NHS Trust, London, UK
  14. 14Department of Gynaecology and Obstetrics, University Hospital Pilsen, Charles University, Prague, Czech Republic
  15. 15Houston Methodist Hospital, Houston, USA
  16. 16Department of Gynecologic Oncology, Zekai Tahir Burak Women’s Health and Research Hospital, University of Health Sciences, Ankara, Türkiye
  17. 17Department of Gynecologic Oncology, Hospital Italiano de Buenos Aires, Instituto Universitario Hospital Italiano, Buenos Aires, Argentina
  18. 18Gynecology, Medical University of Graz, Graz, Austria
  19. 19Gynecologic Oncology Unit, La Paz University Hospital – IdiPAZ, Madrid, Spain
  20. 20University Hospital Brno, Medical Faculty of Masaryk University, Brno, Czech Republic
  21. 21Department of Gynecologic Oncology, Barretos Cancer Hospital, Barretos, Sao Paolo, Brazil
  22. 22Oncology Unit of the Cayetano Heredia Hospital, Lima, Peru
  23. 23Department of Obstetrics and Gynecology, Faculty of Medicine, University Hospital and University of Ostrava, Ostrava, Ostrava, Czech Republic


Introduction/Background The aim of this study was to assess whether increased radicality had an impact on 5-year disease-free survival (DFS) in patients with early-stage cervical cancer undergoing radical hysterectomy. Secondary aims were 5-year overall survival (OS) and pattern of recurrence.

Methodology International, multicenter, retrospective study from the Surveillance in Cervical CANcer (SCCAN) collaborative cohort. Patients with FIGO-2009 stage IB1-IIA1 who underwent open type B/C1/C2 radical hysterectomy according to Querleu-Morrow classification between 01/2007–12/2016, who did not undergo neo-adjuvant chemotherapy and who had negative lymph nodes and free surgical margins at final histology, were included.

Results 1,257 patients were included. 883 (70.2%) underwent nerve sparing and 374 (29.8%) non-nerve sparing radical hysterectomy. 5-year-DFS in patients undergoing nerve sparing versus non-nerve sparing radical hysterectomy was 90.1% (95%CI:87.9–92.2) versus 93.8% (95%CI:91.1–96.5), p=0.047, respectively. Non-nerve sparing radical hysterectomy was independently associated with better DFS at multivariable analysis performed on the entire cohort (HR:0.50,95%CI:0.31–0.81;p=0.004). 5-year-OS was: nerve-sparing 95.7% (95%CI:94.1–97.2) versus non-nerve sparing 96.5% (95%CI:94.3–98.7), p=0.78. In patients with tumor diameter ≤20mm 5-year-DFS was 94.7% in nerve sparing versus 96.2% in non-nerve sparing (p=0.22). 5-year-DFS was 90.3% in non-nerve sparing radical hysterectomy compared with 83.1% in nerve sparing radical hysterectomy (p=0.016) in patients with tumors between 21–40mm (no significant difference in rate of adjuvant treatment in this subgroup, p=0.47). Significant DFS difference was confirmed after propensity match score analysis (balancing the two study groups). Pattern of recurrence in the propensity matched population did not demonstrate any difference (p=0.70).

Conclusion For tumors ≤20mm no survival difference was found with more radical hysterectomy. For tumors between 21–40mm a more radical hysterectomy was associated with improved 5-year-DFS. No difference in pattern of recurrence according to extent of radicality was observed. Non-nerve sparing radical hysterectomy was associated with better 5-year-DFS compared with nerve-sparing radical hysterectomy after propensity score match analysis.

Disclosures None

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