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#771 External validation of the annual recurrence risk model (ARRM) for tailored surveillance strategy in patients with cervical cancer
  1. Luigi ADe Vitis1,2,
  2. Gabriella Schivardi2,1,
  3. Michela Gaiano2,
  4. Simone Bruni2,
  5. Ludovica Nazzaro2,
  6. Giuseppe Caruso1,2,
  7. Ilaria Betella2,
  8. Maria Teresa Achilarre2,
  9. Annalisa Garbi2,
  10. Alessia Aloisi2,
  11. Andrea Mariani1,
  12. Giovanni D Aletti2,3,
  13. Nicoletta Colombo2,4,
  14. Angelo Maggioni2,
  15. Vanna Zanagnolo2 and
  16. Francesco Multinu2,1
  1. 1Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, USA
  2. 2Department of Gynecologic Oncology, European Institute of Oncology, Milan, Italy
  3. 3Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
  4. 4Faculty of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy


Introduction/Background The Annual Recurrence Risk Model (ARRM), which was endorsed by the European Society of Gynecological Oncology, predicts the annual risk of cervical cancer recurrence. However, it lacks an external validation, which we aim to address in the current study.

Methodology We included T1a-T2b cervical cancers undergoing surgery at the European Institute of Oncology, Milan, from 01/2010 to 12/2021, according to the criteria used for model development. After imputing tumor histotype, maximal diameter, grade, number of positive pelvic lymph nodes, and lymph-vascular space invasion, the model provided a score from 0 to 100 points, which allowed classification into five risk groups (0, 1–25, 26–50, 51–75, 76–100 points). Annual risk of recurrence was calculated using conditional survival analysis. Differences in disease-free survival (DFS) were evaluated through Log-rank tests with pairwise comparisons.

Abstract #771 Table 1

a. Clinicopathologic characteristics of included patients (N=344). Table 1b. Annual probability of recurrence after surgery according to the ARRM (Annual Recurrence Risk model) (N=342). Table 1c. Kaplan–Meier curves. Abbreviations: LN, lymph nodes; LVSI, and lymph-vascular space invasion; No., number.

Results Overall, 344 cervical cancers were included (table 1). Of them, 40 (11.6%) experienced a recurrence, with a median time to recurrence of 20.7 months. Groups 0 and 76–100 points were excluded from further analysis as they included only two patients. Five-year DFS was 95.1% [95%CI: 87.1–98.2], 85.5% [95%CI: 79.3%-90.0%], and 72.9% [95%CI: 52.6%-85.6%] in groups 1–25 points (n=120), 26–50 points (n=189), and 51–75 points (n=33), respectively. Significant DFS differences (p<0.001) were observed between groups 1–25 vs. 26–50 points, and 1–25 vs. 51–75 points, but not among 26–50 vs. 51–75 points (p=0.07). In group 1–25 points, the annual risk of recurrence increased from 0.0% in the first year after surgery to 1.7% at 5 years [95%CI: 0.2%-11.4%].

Conclusion The ARRM can stratify cervical cancer into groups with significantly different DFS, even in an independent population from a high-volume tertiary center. However, among the 1–25 points group the annual risk of recurrence from the 3rd year after surgery was greater than 1%, suggesting the need for longer follow-up.

Disclosures Nothing to disclose.

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