RT Journal Article
SR Electronic
T1 898 The impact of micrometastases in cervical cancer patients – a retrospective study of the SCCAN (Surveillance in Cervical CANcer) project
JF International Journal of Gynecologic Cancer
JO Int J Gynecol Cancer
FD BMJ Publishing Group Ltd
SP A50
OP A51
DO 10.1136/ijgc-2021-ESGO.74
VO 31
IS Suppl 3
A1 L Dostalek
A1 M Borcinova
A1 K Benesova
A1 J Klat
A1 H Falconer
A1 SH Kim
A1 LR Van Lonkhuijzen
A1 A Lopez
A1 D Isla Ortiz
A1 F Landoni
A1 J Kostun
A1 R Dos Reis
A1 D Odetto
A1 I Zapardiel
A1 J Jarkovsky
A1 V Javukova
A1 S Salehi
A1 NR Abu-Rustum
A1 P Graf
A1 D Cibula
YR 2021
UL http://ijgc.bmj.com/content/31/Suppl_3/A50.abstract
AB Introduction/Background*The impact of lymph node (LN) micrometastases (MIC) in cervical cancer patients remains a controversial topic given their low incidence and good prognosis of patients managed by primary surgery.We aim to evaluate the prognostic significance of MIC and isolated tumour cells (ITC) in a large cohort of patients from the SCCAN retrospetive study (Surveillance in Cervical CANcer). SCCAN study analysed data from more than 4300 patients with early stage cervical cancer treated by primary surgery at 20 large tertiary institutions from Europe, North America, South America and Australia.Methodology In this SCCAN sub-study, we included patients with early stage cervical cancer (T1a1 LVSI+ – T2b) treated between 2007 and 2016 with at least 1-year follow-up data availability, who underwent primary surgery including sentinel lymph node (SLN) biopsy and in whom SLNs were processed by pathological ultrastaging protocol.Result(s)*Out of 969 included patients with at least 1 SLN detected, 174 (18%) had positive LN (table 1). Maximal tumour diameter >2cm, positive LVSI, grade ≥ 2, uncommon histological type (neuroendocrine, sarcoma, etc.) and macrometstasis (MAC) or MIC in LN were factors associated with significantly decreased five-years disease free survival (DFS) (table 2). MAC, MIC or ITC was the largest LN metastasis in 84 (9%), 59 (6%) and 31 (3%) cases respectively. Adjuvant (chemo)radiation was administred in 89%, 85% and 58% of patients with MAC, MIC and ITC. DFS reached 75%, 73% and 83% in patients with MAC, MIC and ITC compared with 90% in the N0 patients. Patients with MAC and MIC had significantly decreased DFS than those with N0 disease (HR=2.36 and 2.55).Abstract 898 Figure 1 View this table:Abstract 898 Table 1 Data summary (N = 969)View this table:Abstract 898 Table 2 Univariate analysis of factors associated with disease-free survival (N = 969)Conclusion*Early-stage cervical cancer patients with MIC in pelvic LN have significantly decreased DFS. Their management should follow the same principles as in patients with MAC.