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. 2023 Aug;30(8):4975-4985.
doi: 10.1245/s10434-023-13529-w. Epub 2023 May 19.

SUCCOR Nodes: May Sentinel Node Biopsy Determine the Need for Adjuvant Treatment?

Arantxa Berasaluce Gómez #  1 , Nerea Martín-Calvo #  1   2   3 , Félix Boria  4 , Nabil Manzour  5 , Enrique Chacón  5 , Nicolò Bizzarri  6 , Luis Chiva  7 ; SUCCOR Study Group
Collaborators, Affiliations

SUCCOR Nodes: May Sentinel Node Biopsy Determine the Need for Adjuvant Treatment?

Arantxa Berasaluce Gómez et al. Ann Surg Oncol. 2023 Aug.

Abstract

Background: The SUCCOR cohort was developed to analyse the overall and disease-free survival at 5 years in women with FIGO 2009 stage IB1 cervical cancer. The aim of this study was to compare the use of adjuvant therapy in these women, depending on the method used to diagnose lymphatic node metastasis.

Patients and methods: We used data from the SUCCOR cohort, which collected information from 1049 women with FIGO 2009 stage IB1 cervical cancer who were operated on between January 2013 and December 2014 in Europe. We calculated the adjusted proportion of women who received adjuvant therapy depending on the lymph node diagnosis method and compared disease free and overall survival using Cox proportional-hazards regression models. Inverse probability weighting was used to adjust for baseline potential confounders.

Results: The adjusted proportion of women who received adjuvant therapy was 33.8% in the sentinel node biopsy + lymphadenectomy (SNB+LA) group and 44.7% in the LA group (p = 0.02), although the proportion of positive nodal status was similar (p = 0.30). That difference was greater in women with negative nodal status and positive Sedlis criteria (difference 31.2%, p = 0.01). Here, those who underwent a SNB+LA had an increased risk of relapse [hazard ratio (HR) 2.49, 95% confidence interval (CI) 0.98-6.33, p = 0.056] and risk of death (HR 3.49, 95% CI 1.04-11.7, p = 0.042) compared with those who underwent LA.

Conclusions: Women in this study were less likely to receive adjuvant therapy if their nodal invasion was determined using SNB+LA compared with LA. These results suggest a lack of therapeutic measures available when a negative result is obtained by SNB+LA, which may have an impact on the risk of recurrence and survival.

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Conflict of interest statement

All the authors declare no conflict of interest.

Figures

Fig. 1
Fig. 1
Flowchart of participants. SNB sentinel node biopsy, LA lymphadenectomy
Fig. 2
Fig. 2
Nelson–Aalen curve for overall survival of women in the SUCCOR cohort with negative nodal status and positive Sedlis criteria, based on method of diagnosis of lymph node metastasis (lymphadenectomy versus SNB+ lymphadenectomy), adjusted for surgical approach, use of uterine manipulator, lymphovascular space invasion, parametrial space invasion, and conization using the IPW method. SNB sentinel node biopsy, LA lymphadenectomy, HR hazard ratio, CI confidence interval
Fig. 3
Fig. 3
Nelson–Aalen curve for disease free survival of women in the SUCCOR cohort with negative nodal status and positive Sedlis criteria, based on method of diagnosis of lymph node metastasis (SNB versus lymphadenectomy), adjusted for surgical approach, use of uterine manipulator, lymphovascular space invasion, parametrial space invasion and conization using the IPW method. SNB sentinel node biopsy, LA lymphadenectomy, HR hazard ratio, CI confidence interval
See this image and copyright information in PMC

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