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SUCCOR Risk: Design and Validation of a Recurrence Prediction Index for Early-Stage Cervical Cancer

Design and Validation of a Recurrence Prediction Index for Early-Stage Cervical Cancer
Authors: Manzour, Nabil; Chiva, Luis; Chacón, Enrique; Martin-Calvo, Nerea; Boria, Felix; Minguez, José A; Alcazar; +136 Authors

SUCCOR Risk: Design and Validation of a Recurrence Prediction Index for Early-Stage Cervical Cancer

Abstract

Abstract Objective Based on the SUCCOR study database, our primary objective was to identify the independent clinical pathological variables associated with the risk of relapse in patients with stage IB1 cervical cancer who underwent a radical hysterectomy. Our secondary goal was to design and validate a risk predictive index (RPI) for classifying patients depending on the risk of recurrence. Methods Overall, 1116 women were included from January 2013 to December 2014. We randomly divided our sample into two cohorts: discovery and validation cohorts. The test group was used to identify the independent variables associated with relapse, and with these variables, we designed our RPI. The index was applied to calculate a relapse risk score for each participant in the validation group. Results A previous cone biopsy was the most significant independent variable that lowered the rate of relapse (odds ratio [OR] 0.31, 95% confidence interval [CI] 0.17–0.60). Additionally, patients with a tumor diameter >2 cm on preoperative imaging assessment (OR 2.15, 95% CI 1.33–3.5) and operated by the minimally invasive approach (OR 1.61, 95% CI 1.00–2.57) were more likely to have a recurrence. Based on these findings, patients in the validation cohort were classified according to the RPI of low, medium, or high risk of relapse, with rates of 3.4%, 9.8%, and 21.3% observed in each group, respectively. With a median follow-up of 58 months, the 5-year disease-free survival rates were 97.2% for the low-risk group, 88.0% for the medium-risk group, and 80.5% for the high-risk group (p < 0.001). Conclusion Previous conization to radical hysterectomy was the most powerful protective variable of relapse. Our risk predictor index was validated to identify patients at risk of recurrence.

Keywords

cervical cancer, Oncologie, Radboudumc 17: Women's cancers RIHS: Radboud Institute for Health Sciences, Uterine Cervical Neoplasms, Hysterectomy, Hysterectomy / methods, Sciences de la santé humaine, Risk Assessment, Neoplasm Recurrence, Local/diagnosis, 618, conization, Uterine Cervical Neoplasms / pathology, Gynaecology - Radboud University Medical Center, Uterine Cervical Neoplasms/diagnosis, Recurrence, Humans, Hysterectomy/methods, Human health sciences, Neoplasm Recurrence, Local/pathology, Cevical cancer;, Neoplasm Staging, Retrospective Studies, Uterine Cervical Neoplasms/surgery, Uterine Cervical Neoplasms/pathology, Uterine Cervical Neoplasms / surgery, Uterine Cervical Neoplasms / diagnosis, Neoplasm Recurrence, Local / pathology, Gynecologic Oncology, Prognosis, Oncology, radical hysterectomy, Cervical cancer, Surgery, Female, Neoplasm Recurrence, Local, Prediction, Neoplasm Recurrence, Local / diagnosis

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
13
Top 10%
Top 10%
Top 10%
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hybrid