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A Scoring System to Select the Candidates for Adjuvant Chemotherapy Alone in High-Risk Early-Stage Cervical Cancer Patients With Pelvic Lymph Node Metastases After Surgery

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机构： [1]Departments of Radiation Oncology., Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China [2]Departments of Radiology., Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China [3]Departments of Gynecology, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China. [4]Department of Pain, West China Hospital, Sichuan University. [5]Department of Medical Oncology, Sichuan Cancer Hospital and Institute, Chengdu. [6]Department of Oncology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.

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The aim was to build a risk scoring system to guide the adjuvant treatment for early-stage cervical cancer patients with pelvic lymph node (LN) metastases after surgery.A cohort of 1213 early-stage cervical cancer patients with pelvic LN metastases (T1-2aN1M0) were selected from the NCI SEER database, of which 1040 patients received adjuvant external beam radiotherapy concurrent with chemotherapy (EBRT+Chemo) and 173 patients received adjuvant chemotherapy alone. The Cox regression analysis was applied to identify the risk factors associated with worse survival. The exp (β) of each independent risk factors from multivariate analysis was assigned to develop the risk scoring system. The total cohort was divided into different risk subgroups accordingly and the efficacy of different adjuvant modalities in each risk subgroups was compared.The patients were divided into 3 risk subgroups (Low-risk: total score <7.20, Middle-risk:7.20≤ total score≤ 8.40, High-risk: total score<8.40) based on the scoring system incorporating 5 independent risk factors. The survival analysis suggested that low-risk (hazard ratio [HR]=1.046, 95% CI: 0.586-1.867; P=0.879) and middle-risk patients (HR=0.709, 95% CI: 0.459-1.096; P=0.122) could not benefit more from EBRT+Chemo than Chemo alone. However, EBRT+Chemo remained the superiority to Chemo alone in the high-risk subgroup (HR=0.482, 95% CI: 0.294-0.791; P=0.003).A risk scoring system has been built to direct the adjuvant treatment for early-stage cervical cancer patients with pelvic LN metastases after surgery, where Chemo alone was totally enough for low-risk and middle-risk patients stratified by the model while EBRT+Chemo was still recommended for patients in the high-risk subgroup.Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.

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出版当年[2023]版：

大类 | 4 区医学

小类 | 4 区肿瘤学

最新[2023]版：

大类 | 4 区医学

小类 | 4 区肿瘤学

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出版当年[2023]版：

Q4 ONCOLOGY

最新[2023]版：

Q4 ONCOLOGY

影响因子： 1.6 最新[2023版] 2 最新五年平均 1.6 出版当年[2023版] 2 出版当年五年平均 2.6 出版前一年[2022版]

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第一作者机构： [1]Departments of Radiation Oncology., Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China

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通讯机构： [1]Departments of Radiation Oncology., Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China [6]Department of Oncology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China. [*1]No. 1617 of Riyue Avenue, Qingyang District, Chengdu 611731, China. [*2]No. 1 of Youyi Road, Yuzhong District, Chongqing 400000, China

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