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

作者全名："Yang, Xi-Lin; Yang, Feng-Leng; Wang, Na; Zhang, Yue-Er; Kou, Ling-Na; Wu, Da-Jun; Luo, Yi"

作者地址："[Yang, Xi-Lin; Wu, Da-Jun] Univ Elect Sci & Technol China, Chengdu Womens & Childrens Cent Hosp, Sch Med, Dept Radiat Oncol, Chengdu, Peoples R China; [Yang, Feng-Leng] Univ Elect Sci & Technol China, Chengdu Womens & Childrens Cent Hosp, Sch Med, Dept Radiol, Chengdu, Peoples R China; [Wang, Na] Univ Elect Sci & Technol China, Chengdu Womens & Childrens Cent Hosp, Sch Med, Dept Gynecol, Chengdu, Peoples R China; [Zhang, Yue-Er] Sichuan Univ, West China Hosp, Dept Pain, Chengdu, Peoples R China; [Kou, Ling-Na] Sichuan Canc Hosp & Inst, Dept Med Oncol, Chengdu, Peoples R China; [Luo, Yi] Chongqing Med Univ, Affiliated Hosp 1, Dept Oncol, Chongqing, Peoples R China; [Wu, Da-Jun] 1617 Riyue Ave, Chengdu 611731, Peoples R China; [Luo, Yi] 1 Youyi Rd, Chongqing 400000, Peoples R China"

通信作者："Wu, DJ (通讯作者)，1617 Riyue Ave, Chengdu 611731, Peoples R China.; Luo, Y (通讯作者)，1 Youyi Rd, Chongqing 400000, Peoples R China."

来源：AMERICAN JOURNAL OF CLINICAL ONCOLOGY-CANCER CLINICAL TRIALS

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:000977082200006

JCR分区：Q4

影响因子：1.6

年份：2023

卷号：46

期号：5

开始页：219

结束页：224

文献类型：Article

关键词：cervical cancer; early-stage; pelvic lymph node metastases; chemoradiotherapy; chemotherapy alone

摘要："Background: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. Methods: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 (beta) 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. Results: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). Conclusion: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."

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