Identification of a low risk population for parametrial invasion in patients with early-stage cervical cancer
Abstract Background Recent studies have challenged radical procedures for less extensive surgery in selected patients with early-stage cervical cancer at low risk of parametrial invasion. Our objective was to identify a subgroup of patients at low risk of parametrial invasion among women having unde...
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Format: | Article |
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BMC
2018-06-01
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Series: | Journal of Translational Medicine |
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Online Access: | http://link.springer.com/article/10.1186/s12967-018-1531-6 |
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doaj-509ff5dff66e4f09931550428e75cca9 |
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Article |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Yohann Dabi Claire Willecocq Marcos Ballester Xavier Carcopino Sofiane Bendifallah Lobna Ouldamer Vincent Lavoue Geoffroy Canlorbe Emilie Raimond Charles Coutant Olivier Graesslin Pierre Collinet Alexandre Bricou Cyrille Huchon Emile Daraï Bassam Haddad Cyril Touboul For the Groupe de Recherche FRANCOGYN |
spellingShingle |
Yohann Dabi Claire Willecocq Marcos Ballester Xavier Carcopino Sofiane Bendifallah Lobna Ouldamer Vincent Lavoue Geoffroy Canlorbe Emilie Raimond Charles Coutant Olivier Graesslin Pierre Collinet Alexandre Bricou Cyrille Huchon Emile Daraï Bassam Haddad Cyril Touboul For the Groupe de Recherche FRANCOGYN Identification of a low risk population for parametrial invasion in patients with early-stage cervical cancer Journal of Translational Medicine Cervical cancer Early-stage Radical surgery Predicting Parametrial invasion Low-risk |
author_facet |
Yohann Dabi Claire Willecocq Marcos Ballester Xavier Carcopino Sofiane Bendifallah Lobna Ouldamer Vincent Lavoue Geoffroy Canlorbe Emilie Raimond Charles Coutant Olivier Graesslin Pierre Collinet Alexandre Bricou Cyrille Huchon Emile Daraï Bassam Haddad Cyril Touboul For the Groupe de Recherche FRANCOGYN |
author_sort |
Yohann Dabi |
title |
Identification of a low risk population for parametrial invasion in patients with early-stage cervical cancer |
title_short |
Identification of a low risk population for parametrial invasion in patients with early-stage cervical cancer |
title_full |
Identification of a low risk population for parametrial invasion in patients with early-stage cervical cancer |
title_fullStr |
Identification of a low risk population for parametrial invasion in patients with early-stage cervical cancer |
title_full_unstemmed |
Identification of a low risk population for parametrial invasion in patients with early-stage cervical cancer |
title_sort |
identification of a low risk population for parametrial invasion in patients with early-stage cervical cancer |
publisher |
BMC |
series |
Journal of Translational Medicine |
issn |
1479-5876 |
publishDate |
2018-06-01 |
description |
Abstract Background Recent studies have challenged radical procedures for less extensive surgery in selected patients with early-stage cervical cancer at low risk of parametrial invasion. Our objective was to identify a subgroup of patients at low risk of parametrial invasion among women having undergone surgical treatment. Methods Data of 1447 patients with cervical cancer treated between 1996 and 2016 were extracted from maintained databases of 10 French University hospitals. Patients with early-stage (IA2–IIA) disease treated by radical surgery including hysterectomy and trachelectomy, were selected for further analysis. The Kaplan–Meier method was used to estimate the survival distribution. A Cox proportional hazards model including all the parameters statistically significant in univariate analysis, was used to account for the influence of multiple variables. Results Out of the 263 patients included for analysis, on final pathology analysis 28 (10.6%) had parametrial invasion and 235 (89.4%) did not. Factors significantly associated with parametrial invasion on multivariate analysis were: age > 65 years, tumor > 30 mm in diameter measured by MRI, lymphovascular space invasion (LVSI) on pathologic analysis. Among the 235 patients with negative pelvic lymph nodes, parametrial disease was seen in only 7.6% compared with 30.8% of those with positive pelvic nodes (p < 0.001). In a subgroup of patients presenting tumors < 30 mm, negative pelvic status and no LVSI, the risk of parametrial invasion fell to 0.6% (1/173 patients). Conclusion Our analysis suggests that there is a subgroup of patients at very low risk of parametrial invasion, potentially eligible for less radical procedures. |
topic |
Cervical cancer Early-stage Radical surgery Predicting Parametrial invasion Low-risk |
url |
http://link.springer.com/article/10.1186/s12967-018-1531-6 |
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doaj-509ff5dff66e4f09931550428e75cca92020-11-25T00:12:11ZengBMCJournal of Translational Medicine1479-58762018-06-011611910.1186/s12967-018-1531-6Identification of a low risk population for parametrial invasion in patients with early-stage cervical cancerYohann Dabi0Claire Willecocq1Marcos Ballester2Xavier Carcopino3Sofiane Bendifallah4Lobna Ouldamer5Vincent Lavoue6Geoffroy Canlorbe7Emilie Raimond8Charles Coutant9Olivier Graesslin10Pierre Collinet11Alexandre Bricou12Cyrille Huchon13Emile Daraï14Bassam Haddad15Cyril Touboul16For the Groupe de Recherche FRANCOGYNDepartment of Obstetrics and Gynecology, Centre Hospitalier IntercommunalDepartment of Obstetrics and Gynecology, Centre Hospitalier IntercommunalDepartment of Gynaecology and Obstetrics, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), University Pierre and Marie Curie, Paris 6, Institut Universitaire de Cancérologie (IUC)Department of Obstetrics and Gynecology, Hopital Nord, APHMDepartment of Gynaecology and Obstetrics, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), University Pierre and Marie Curie, Paris 6, Institut Universitaire de Cancérologie (IUC)Department of Obstetrics and Gynaecology, Centre Hospitalier Régional Universitaire de Tours, Hôpital BretonneauCRLCC Eugène-Marquis, Service de Gynécologie, CHU de Rennes, Université de Rennes 1Department of Gynaecology and Obstetrics, Pitié Salpetrière University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), University Pierre and Marie Curie, Paris 6, Institut Universitaire de Cancérologie (IUC)Department of Obstetrics and Gynaecology, Institute Alix de Champagne University HospitalCentre de lutte contre le cancer Georges François LeclercDepartment of Obstetrics and Gynaecology, Institute Alix de Champagne University HospitalDepartment of Obstetrics and Gynecology, Centre Hospitalier Régional UniversitaireDepartment of Obstetrics and Gynecology, Jean-Verdier University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP)EA 7285 Research Unit “Risk and Safety in Clinical Medicine for Women and Perinatal Health”, Versailles-Saint-Quentin University (UVSQ)Department of Gynaecology and Obstetrics, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), University Pierre and Marie Curie, Paris 6, Institut Universitaire de Cancérologie (IUC)Department of Obstetrics and Gynecology, Centre Hospitalier IntercommunalDepartment of Obstetrics and Gynecology, Centre Hospitalier IntercommunalAbstract Background Recent studies have challenged radical procedures for less extensive surgery in selected patients with early-stage cervical cancer at low risk of parametrial invasion. Our objective was to identify a subgroup of patients at low risk of parametrial invasion among women having undergone surgical treatment. Methods Data of 1447 patients with cervical cancer treated between 1996 and 2016 were extracted from maintained databases of 10 French University hospitals. Patients with early-stage (IA2–IIA) disease treated by radical surgery including hysterectomy and trachelectomy, were selected for further analysis. The Kaplan–Meier method was used to estimate the survival distribution. A Cox proportional hazards model including all the parameters statistically significant in univariate analysis, was used to account for the influence of multiple variables. Results Out of the 263 patients included for analysis, on final pathology analysis 28 (10.6%) had parametrial invasion and 235 (89.4%) did not. Factors significantly associated with parametrial invasion on multivariate analysis were: age > 65 years, tumor > 30 mm in diameter measured by MRI, lymphovascular space invasion (LVSI) on pathologic analysis. Among the 235 patients with negative pelvic lymph nodes, parametrial disease was seen in only 7.6% compared with 30.8% of those with positive pelvic nodes (p < 0.001). In a subgroup of patients presenting tumors < 30 mm, negative pelvic status and no LVSI, the risk of parametrial invasion fell to 0.6% (1/173 patients). Conclusion Our analysis suggests that there is a subgroup of patients at very low risk of parametrial invasion, potentially eligible for less radical procedures.http://link.springer.com/article/10.1186/s12967-018-1531-6Cervical cancerEarly-stageRadical surgeryPredictingParametrial invasionLow-risk |