303ccc1e054f2f60a34eab3622592e76 pmc_11011205.pdf f703625f565d539b46bef89d73c51f6934594e69 pmc_11011205.pdf d32d19b5323621f0e26b1389e921ff49f05c541c0f5b3180e4b1a3eb3cdbaf2c pmc_11011205.pdf Title: Patterns of First Recurrence and Oncological Outcomes in Locally Advanced Cervical Cancer Patients: Does Surgical Staging Play a Role? Subject: Background: We aimed to determine whether surgical aortic staging by minimally invasive paraaortic lymphadenectomy (PALND) affects the pattern of first recurrence and survival in treated locally advanced cervical cancer (LACC) patients when compared to patients staged by imaging (noPALND). Methods: This study was a multicenter observational retrospective cohort study of patients with LACC treated at tertiary care hospitals throughout Spain. The inclusion criteria were histological diagnosis of squamous carcinoma, adenosquamous carcinoma, and/or adenocarcinoma; FIGO stages IB2, IIA2-IVA (FIGO 2009); and planned treatment with primary chemoradiotherapy between 2000 and 2016. Propensity score matching (PSM) was performed before the analysis. Results: After PSM and sample replacement, 1092 patients were included for analysis (noPALND n = 546, PALND n = 546). Twenty-one percent of patients recurred during follow-up, with the PALND group having almost double the recurrences of the noPALND group (noPALND: 15.0%, PALND: 28.0%, p < 0.001). Nodal (regional) recurrences were more frequently observed in PALND patients (noPALND:2.4%, PALND: 11.2%, p < 0.001). Among those who recurred regionally, 57.1% recurred at the pelvic nodes, 37.1% recurred at the aortic nodes, and 5.7% recurred simultaneously at both the pelvic and aortic nodes. Patients who underwent a staging PALND were more frequently diagnosed with a distant recurrence (noPALND: 7.0%, PALND: 15.6%, p < 0.001). PALND patients presented poorer overall, cancer-specific, and disease-free survival when compared to patients in the noPALND group. Conclusion: After treatment, surgically staged patients with LACC recurred more frequently and showed worse survival rates. Keywords: cervical cancer; aortic lymphadenectomy; surgical staging Author: Vicente Bebia, Berta Díaz-Feijoo, Álvaro Tejerizo, Aureli Torne, Virginia Benito, Alicia Hernández, Mikel Gorostidi, Santiago Domingo, Melissa Bradbury, Rocío Luna-Guibourg and Antonio Gil-Moreno Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Sat Apr 6 14:05:47 2024 CEST ModDate: Sat Apr 6 14:11:36 2024 CEST Custom Metadata: no Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 11 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 1222465 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- YXDTOY+VnURWPalladioL-Bold Type 1 Custom yes yes no 10 0 IKACGN+URWPalladioL-Bold Type 1 Custom yes yes no 15 0 UPNZCO+URWPalladioL-Roma Type 1 Custom yes yes no 20 0 GOHSQZ+URWPalladioL-Ital Type 1 Custom yes yes no 24 0 DVHPBD+VnURWPalladioL Type 1 Custom yes yes no 28 0 LCJEVJ+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 47 0 PDTLUH+CMSY10 Type 1 Builtin yes yes no 68 0 JLZORU+EURM10 Type 1 Builtin yes yes no 72 0 WBVKDJ+URWPalladioL-BoldItal Type 1 Custom yes yes no 79 0 NAMHIE+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 89 0 NAMHIG+PalatinoLinotype TrueType WinAnsi yes yes no 92 0 NAMHII+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 95 0 NAMHIE+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 109 0 NAMHIG+PalatinoLinotype TrueType WinAnsi yes yes no 112 0 NAMHII+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 115 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2024-05-01 02:42:11 CEST RepresentationInformation: pmc_11011205.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2024-04-24 02:31:13 CEST Size: 1222465 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 248 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: section.1 Item: Title: Material and Methods Destination: section.2 Children: Item: Title: Aortic Lymph Node Assessment and Primary Treatment Destination: subsection.2.1 Item: Title: Recurrence Diagnosis Destination: subsection.2.2 Item: Title: Statistical Analysis Destination: subsection.2.3 Item: Title: Results Destination: section.3 Item: Title: Discussion Destination: section.4 Children: Item: Title: Summary of Main Results Destination: subsection.4.1 Item: Title: Results in the Context of the Published Literature Destination: subsection.4.2 Item: Title: Strengths and Weaknesses Destination: subsection.4.3 Item: Title: Implications for Practice and Future Research Destination: subsection.4.4 Item: Title: Conclusions Destination: section.5 Item: Title: References Destination: section.A. Info: Title: Patterns of First Recurrence and Oncological Outcomes in Locally Advanced Cervical Cancer Patients: Does Surgical Staging Play a Role? Author: Vicente Bebia, Berta Díaz-Feijoo, Álvaro Tejerizo, Aureli Torne, Virginia Benito, Alicia Hernández, Mikel Gorostidi, Santiago Domingo, Melissa Bradbury, Rocío Luna-Guibourg and Antonio Gil-Moreno Subject: Background: We aimed to determine whether surgical aortic staging by minimally invasive paraaortic lymphadenectomy (PALND) affects the pattern of first recurrence and survival in treated locally advanced cervical cancer (LACC) patients when compared to patients staged by imaging (noPALND). Methods: This study was a multicenter observational retrospective cohort study of patients with LACC treated at tertiary care hospitals throughout Spain. The inclusion criteria were histological diagnosis of squamous carcinoma, adenosquamous carcinoma, and/or adenocarcinoma; FIGO stages IB2, IIA2-IVA (FIGO 2009); and planned treatment with primary chemoradiotherapy between 2000 and 2016. Propensity score matching (PSM) was performed before the analysis. Results: After PSM and sample replacement, 1092 patients were included for analysis (noPALND n = 546, PALND n = 546). Twenty-one percent of patients recurred during follow-up, with the PALND group having almost double the recurrences of the noPALND group (noPALND: 15.0%, PALND: 28.0%, p < 0.001). Nodal (regional) recurrences were more frequently observed in PALND patients (noPALND:2.4%, PALND: 11.2%, p < 0.001). Among those who recurred regionally, 57.1% recurred at the pelvic nodes, 37.1% recurred at the aortic nodes, and 5.7% recurred simultaneously at both the pelvic and aortic nodes. Patients who underwent a staging PALND were more frequently diagnosed with a distant recurrence (noPALND: 7.0%, PALND: 15.6%, p < 0.001). PALND patients presented poorer overall, cancer-specific, and disease-free survival when compared to patients in the noPALND group. Conclusion: After treatment, surgically staged patients with LACC recurred more frequently and showed worse survival rates. 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