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SUCCOR Nodes: May Sentinel Node Biopsy Determine the Need for Adjuvant Treatment?
Arantxa Berasaluce Gómez1, Nerea Martín-Calvo1,2,3, Félix Boria4
1Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, Spain.
Annals of Surgical Oncology
|May 19, 2023
Summary
Women with early-stage cervical cancer receiving sentinel lymph node biopsy plus lymphadenectomy (SNB+LA) were less likely to get adjuvant therapy than those undergoing lymphadenectomy (LA) alone. This may increase their risk of recurrence and death.
Area of Science:
- Gynecologic Oncology
- Surgical Pathology
- Clinical Trial Analysis
Background:
- The SUCCOR cohort study investigated 5-year survival in early-stage cervical cancer.
- Focus on FIGO 2009 stage IB1 cervical cancer patients undergoing surgery.
- Comparison of adjuvant therapy based on lymphatic node metastasis diagnosis.
Purpose of the Study:
- To compare adjuvant therapy use in early-stage cervical cancer patients.
- To evaluate the impact of different lymph node metastasis diagnostic methods.
- To analyze disease-free and overall survival rates based on treatment decisions.
Main Methods:
- Analysis of data from 1049 women in the SUCCOR cohort (2013-2014).
- Comparison of adjuvant therapy proportions based on sentinel node biopsy plus lymphadenectomy (SNB+LA) versus lymphadenectomy (LA) alone.
- Cox proportional-hazards regression models used to compare survival outcomes, with inverse probability weighting for confounder adjustment.
Main Results:
- Adjuvant therapy was less common in the SNB+LA group (33.8%) compared to the LA group (44.7%).
- This difference was more pronounced in patients with negative nodal status and positive Sedlis criteria.
- SNB+LA was associated with an increased risk of relapse (HR 2.49) and death (HR 3.49) compared to LA.
Conclusions:
- Fewer women received adjuvant therapy when nodal invasion was diagnosed via SNB+LA compared to LA.
- Suggests potential limitations in therapeutic options following negative SNB+LA results.
- This may negatively impact recurrence risk and survival outcomes in early-stage cervical cancer patients.
