The annual recurrence risk model for tailored surveillance strategy in patients with cervical cancer

Anna Fagotti, David Cibula, Lukáš Dostálek, Jiri Jarkovsky, Constantijne H. Mom, Aldo Lopez, Henrik Falconer, Ali Ayhan, Sarah H. Kim, David Isla Ortiz, Jaroslav Klat, Andreas Obermair, Fabio Landoni, Juliana Rodriguez, Ranjit Manchanda, Jan Kosťun, Ricardo Dos Reis, Mehmet M. Meydanli, Diego Odetto, Rene LakyIgnacio Zapardiel, Vit Weinberger, Klára Benešová, Martina Borčinová, Darwin Pari, Sahar Salehi, Huseyin Akilli, Nadeem R. Abu-Rustum, Rosa A. Salcedo-Hernández, Veronika Javůrková, Jiří Sláma, Luc R.C.W. Van Lonkhuijzen

Risultato della ricerca: Contributo in rivistaArticolo in rivista

Abstract

Purpose: Current guidelines for surveillance strategy in cervical cancer are rigid, recommending the same strategy for all survivors. The aim of this study was to develop a robust model allowing for individualised surveillance based on a patient's risk profile. Methods: Data of 4343 early-stage patients with cervical cancer treated between 2007 and 2016 were obtained from the international SCCAN (Surveillance in Cervical Cancer) consortium. The Cox proportional hazards model predicting disease-free survival (DFS) was developed and internally validated. The risk score, derived from regression coefficients of the model, stratified the cohort into significantly distinctive risk groups. On its basis, the annual recurrence risk model (ARRM) was calculated. Results: Five variables were included in the prognostic model: maximal pathologic tumour diameter; tumour histotype; grade; number of positive pelvic lymph nodes; and lymphovascular space invasion. Five risk groups significantly differing in prognosis were identified with a five-year DFS of 97.5%, 94.7%, 85.2% and 63.3% in increasing risk groups, whereas a two-year DFS in the highest risk group equalled 15.4%. Based on the ARRM, the annual recurrence risk in the lowest risk group was below 1% since the beginning of follow-up and declined below 1% at years three, four and >5 in the medium-risk groups. In the whole cohort, 26% of recurrences appeared at the first year of the follow-up, 48% by year two and 78% by year five. Conclusion: The ARRM represents a potent tool for tailoring the surveillance strategy in early-stage patients with cervical cancer based on the patient's risk status and respective annual recurrence risk. It can easily be used in routine clinical settings internationally.
Lingua originaleEnglish
pagine (da-a)111-122
Numero di pagine12
RivistaEuropean Journal of Cancer
Volume158
DOI
Stato di pubblicazionePubblicato - 2021

Keywords

  • Annual recurrence risk
  • Surveillance
  • Prognostic model
  • Cervical cancer

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