The Trend and Outcome of Postsurgical Therapy for High-risk Early-stage Cervical Cancer with Lymph Node Metastasis in Japan: a Report from the Japan Society of Gynecologic Oncology (JSGO) Guidelines Evaluation Committee

Overview

Journal J Gynecol Oncol

Specialties Gynecology & Obstetrics
Oncology

Date 2021 Apr 7

PMID 33825359

Citations 6

Authors

Masae Ikeda

Masako Shida

Shogo Shigeta

Satoru Nagase

Fumiaki Takahashi

Wataru Yamagami

Hidetaka Katabuchi

Nobuo Yaegashi

Daisuke Aoki

Mikio Mikami

Affiliations

Soon will be listed here.

Abstract

Objective: The Japan Society of Gynecologic Oncology published the first guidelines for the treatment of cervical cancer in 2007. The aim of this research was to evaluate the influence of the introduction of the first guideline on clinical trends and outcomes of patients with early-stage cervical cancer who underwent surgery.

Methods: This analysis included 9,756 patients who were diagnosed based on the pathological Tumor-Node-Metastasis (pTNM) classification (i.e., pT1b1, pT1b2, pT2b and pN0, pN1, pNX) and received surgery as a primary treatment between 2004 and 2009. Data of these patients were retrospectively reviewed, and clinicopathological trends were assessed. The influence of the introduction of the guideline on survival was determined by using a competing risk model.

Results: For surgery cases, the estimated subdistribution hazard ratio (HR) by the competing risk model for the influence of the guideline adjusted for age, year of registration, pT classification, pN classification, histological type, and treatment methods was 1.024 (p=0.864). Following the introduction of the first guideline in 2007, for patients with lymph node metastasis, the use of chemotherapy (CT) as a postsurgical therapy increased, whereas that of concurrent chemoradiotherapy (CCRT)/radiotherapy (RT) decreased (p<0.010). For pN1 cases, the estimated subdistribution HR by the competing risk model for the influence of the guideline was 1.094 (p=0.634). There was no significance in the postsurgical therapy between CT and CCRT/RT (p=0.078).

Conclusions: Survival of surgical cases was not improved by the introduction of the guidelines. It is necessary to consider more effective postsurgical therapy for high-risk early-stage cervical cancer.

Citing Articles

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CLPTM1L expression predicts recurrence of patients with intermediate‑ and high‑risk stage IB‑IIB cervical cancer undergoing radical hysterectomy followed by TP as adjuvant chemotherapy.

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Shigeta S, Shimada M, Tsuji K, Watanabe Z, Tanase Y, Matsuo K Sci Rep. 2023; 13(1):12020.

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Construction of prediction model of lymph node metastasis of early cervical cancer based on machine learning algorithm and its application: experience of 204 cases in a single center.

Meng Y, Yan X, Fan J Am J Transl Res. 2023; 15(3):1852-1861.

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Risk assessment in the patients with uterine cervical cancer harboring intermediate risk factors after radical hysterectomy: a multicenter, retrospective analysis by the Japanese Gynecologic Oncology Group.

Shigeta S, Shimada M, Tsuji K, Nagai T, Tanase Y, Matsuo K Int J Clin Oncol. 2022; 27(9):1507-1515.

PMID: 35701640 DOI: 10.1007/s10147-022-02198-6.

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