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Poster/ePoster Sessions
01. Cervical cancer
#666 Predictors of recurrence in surgically staged intermediate-risk early-stage cervical cancer
Free
  1. Valeria Artuso1,
  2. Tommaso Meschini1,
  3. Gabriella Schivardi2,
  4. Luigi Antonio De Vitis3,
  5. Francesco Multinu2,
  6. Nerea Martin-Calvo4,
  7. Luis Chiva5,
  8. Fabio Ghezzi1 and
  9. Jvan Casarin1
  1. 1Department of Obstetrics and Gynecology, Women’s and Children’s Del Ponte Hospital, University of Insubria, Varese, Italy
  2. 2Department of Gynecologic Surgery, IRCCS European Institute of Oncology, Milan, Italy
  3. 3Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, Mn, USA
  4. 4Department of Preventive Medicine and Public Health, Universidad de Navarra, Pamplona, Spain
  5. 5Department of Obstetrics and Gynecology, Clinica Universidad de Navarra, Madrid, Spain

Abstract

Introduction/Background The Sedlis criteria [a) lymphovascular space invasion, b) depth of invasion, c) tumour diameter] have long been considered primary predictors of recurrence in early-stage cervical cancer. Consequently, over the past decades they have served as the primary indication for determining the need for adjuvant treatment. However, the LACC trial findings have highlighted the significance of non-histological risk factors in predicting recurrence, raising concerns regarding the need to reassess treatment planning.

Methodology A retrospective analysis was conducted on intermediate-risk cervical cancer (FIGO-2009 stage IB1 with negative nodes at final pathology) of the SUCCOR study database. Univariate and multivariable Cox proportional hazards models were used to evaluate independent risk factors for disease-free survival (DFS). Survival curves were generated using the Kaplan-Meier method and compared using log-rank test.

Results The study included 572 patients, of whom 67 (11.7%) experienced recurrence. In the univariate analysis, Minimally Invasive Surgery (MIS) and the use of uterine manipulator were found to be associated with an increased risk of recurrence (p<0.001), while preoperative conization was identified as a protective factor (p 0.002). Patients aged over 50 years were more likely to experience recurrence (p 0.04), while no other baseline characteristics examined appeared to have an influence on the risk of recurrence.

Among the conventional histologic risk factors, only tumour diameter, specifically when ≥2 cm, was found to be associated with an elevated risk of recurrence (p 0.006). The Kaplan-Meier curves illustrating disease-free survival were stratified by surgical approach and tumour diameter, and the results for the three different models are presented below.

Abstract #666 Figure 1
Abstract #666 Figure 1

Conclusion MIS was confirmed as the strongest predictor of recurrence in surgically treated FIGO-2009 stage IB1 cervical cancer with negative lymph nodes. Among the Sedlis criteria, tumour diameter and deep stromal invasion were identified as the only factors negatively impacting DFS.

Disclosures none

https://doi.org/10.1136/ijgc-2023-ESGO.174

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