Role of adjuvant therapy in intermediate-risk cervical cancer patients - Subanalyses of the SCCAN study

David Cibula, Huseyin Akilli, Jiri Jarkovsky, Luc Van Lonkhuijzen, Giovanni Scambia, Mehmet Mutlu Meydanli, David Isla Ortiz, Henrik Falconer, Nadeem R. Abu-Rustum, Diego Odetto, Jaroslav Klát, Ricardo Dos Reis, Ignacio Zapardiel, Giampaolo Di Martino, Jiri Presl, Rene Laky, Aldo López, Vit Weinberger, Andreas Obermair, Rene ParejaRenata Poncová, Constantijne Mom, Nicolò Bizzarri, Martina Borčinová, Koray Aslan, Rosa Angélica Salcedo Hernandez, Guus Fons, Klára Benešová, Lukáš Dostálek, Ali Ayhan

Risultato della ricerca: Contributo in rivistaArticolo in rivista


Objective. The "intermediate-risk" (IR) group of early-stage cervical cancer patients is characterized by nega-tive pelvic lymph nodes and a combination of tumor-related prognostic risk factors such as tumor size >= 2 cm, lymphovascular space invasion (LVSI), and deep stromal invasion. However, the role of adjuvant treatment in these patients remains controversial. We investigated whether adjuvant (chemo)radiation is associated with a survival benefit after radical surgery in patients with IR cervical cancer. Methods. We analyzed data from patients with IR cervical cancer (tumor size 2-4 cm plus LVSI OR tumor size >4 cm; N0; no parametrial invasion; clear surgical margins) who underwent primary curative-intent surgery between 2007 and 2016 and were retrospectively registered in the international multicenter Surveillance in Cervical CANcer (SCCAN) study. Results. Of 692 analyzed patients, 274 (39.6%) received no adjuvant treatment (AT-) and 418 (60.4%) re-ceived radiotherapy or chemoradiotherapy (AT+). The 5-year disease-free survival (83.2% and 80.3%; PDFS = 0.365) and overall survival (88.7% and 89.0%; POS = 0.281) were not significantly different between the AT- and AT+ groups, respectively. Adjuvant (chemo)radiotherapy was not associated with a survival benefit after adjusting for confounding factors by case-control propensity score matching or in subgroup analyses of patients with tumor size >= 4 cm and <4 cm. In univariable analysis, adjuvant (chemo)radiotherapy was not identified as a prognostic factor in any of the subgroups (full cohort: PDFS = 0.365; POS = 0.282). Conclusion. Among patients with IR early-stage cervical cancer, radical surgery alone achieved equal disease -free and overall survival rates to those achieved by combining radical surgery with adjuvant (chemo)radiotherapy. (c) 2023 Elsevier Inc. All rights reserved.
Lingua originaleEnglish
pagine (da-a)195-202
Numero di pagine8
RivistaGynecologic Oncology
Stato di pubblicazionePubblicato - 2023


  • Adjuvant treatment
  • Cervical cancer
  • Radiotherapy
  • Intermediate risk
  • Radial surgery
  • GOG criteria


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