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Journal Article Ppublish 5 citations

PubMed: 37208571 DOI: 10.1245/s10434-023-13529-w

SUCCOR Nodes: May Sentinel Node Biopsy Determine the Need for Adjuvant Treatment?

Ann Surg Oncol 30(8):4975-4985

Authors: Arantxa Berasaluce Gómez, Nerea Martín-Calvo, Félix Boria, Nabil Manzour, Enrique Chacón, Nicolò Bizzarri, Luis Chiva

Affiliations

  • Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, Spain.
  • IdiSNA, Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain.
  • CIBER de Fisiopatología de la Obesidad y la Nutrición, Instituto de Salud Carlos III, Madrid, Spain.
  • Department of Obstetrics and Gynecology, Universidad de Navarra Clinic, Madrid, Spain.
  • Department of Obstetrics and Gynecology, Universidad de Navarra Clinic, Pamplona, Spain.
  • Dipartimento per la Salute della Donna e del Bambino e della Salute Pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS, UOC Ginecologia Oncologica, Rome, Italy.
  • Department of Obstetrics and Gynecology, Universidad de Navarra Clinic, Madrid, Spain.

Abstract

BACKGROUND

The SUCCOR cohort was developed to analyse the overall and disease-free survival at 5 years in women with FIGO 2009 stage IB1 cervical cancer. The aim of this study was to compare the use of adjuvant therapy in these women, depending on the method used to diagnose lymphatic node metastasis.

PATIENTS AND METHODS

We used data from the SUCCOR cohort, which collected information from 1049 women with FIGO 2009 stage IB1 cervical cancer who were operated on between January 2013 and December 2014 in Europe. We calculated the adjusted proportion of women who received adjuvant therapy depending on the lymph node diagnosis method and compared disease free and overall survival using Cox proportional-hazards regression models. Inverse probability weighting was used to adjust for baseline potential confounders.

RESULTS

The adjusted proportion of women who received adjuvant therapy was 33.8% in the sentinel node biopsy + lymphadenectomy (SNB+LA) group and 44.7% in the LA group (p = 0.02), although the proportion of positive nodal status was similar (p = 0.30). That difference was greater in women with negative nodal status and positive Sedlis criteria (difference 31.2%, p = 0.01). Here, those who underwent a SNB+LA had an increased risk of relapse [hazard ratio (HR) 2.49, 95% confidence interval (CI) 0.98-6.33, p = 0.056] and risk of death (HR 3.49, 95% CI 1.04-11.7, p = 0.042) compared with those who underwent LA.

CONCLUSIONS

Women in this study were less likely to receive adjuvant therapy if their nodal invasion was determined using SNB+LA compared with LA. These results suggest a lack of therapeutic measures available when a negative result is obtained by SNB+LA, which may have an impact on the risk of recurrence and survival.

MeSH

Uterine Cervical Neoplasms, Neoplasms, Biopsy, Lymph, Diagnosis, Therapeutics