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01-12-2015 | Gynecologic Oncology

When Does Neoadjuvant Chemotherapy Really Avoid Radiotherapy? Clinical Predictors of Adjuvant Radiotherapy in Cervical Cancer

Authors: Andrea Papadia, MD, PhD, Filippo Bellati, MD, PhD, Giorgio Bogani, MD, Antonino Ditto, MD, Fabio Martinelli, MD, Domenica Lorusso, MD, Cristina Donfrancesco, MD, Maria Luisa Gasparri, MD, Francesco Raspagliesi, MD

Published in: Annals of Surgical Oncology | Special Issue 3/2015

Abstract

Background

The aim of this study was to identify clinical variables that may predict the need for adjuvant radiotherapy after neoadjuvant chemotherapy (NACT) and radical surgery in locally advanced cervical cancer patients.

Methods

A retrospective series of cervical cancer patients with International Federation of Gynecology and Obstetrics (FIGO) stages IB2–IIB treated with NACT followed by radical surgery was analyzed. Clinical predictors of persistence of intermediate- and/or high-risk factors at final pathological analysis were investigated. Statistical analysis was performed using univariate and multivariate analysis and using a model based on artificial intelligence known as artificial neuronal network (ANN) analysis.

Results

Overall, 101 patients were available for the analyses. Fifty-two (51 %) patients were considered at high risk secondary to parametrial, resection margin and/or lymph node involvement. When disease was confined to the cervix, four (4 %) patients were considered at intermediate risk. At univariate analysis, FIGO grade 3, stage IIB disease at diagnosis and the presence of enlarged nodes before NACT predicted the presence of intermediate- and/or high-risk factors at final pathological analysis. At multivariate analysis, only FIGO grade 3 and tumor diameter maintained statistical significance. The specificity of ANN models in evaluating predictive variables was slightly superior to conventional multivariable models.

Conclusions

FIGO grade, stage, tumor diameter, and histology are associated with persistence of pathological intermediate- and/or high-risk factors after NACT and radical surgery. This information is useful in counseling patients at the time of treatment planning with regard to the probability of being subjected to pelvic radiotherapy after completion of the initially planned treatment.

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Title: When Does Neoadjuvant Chemotherapy Really Avoid Radiotherapy? Clinical Predictors of Adjuvant Radiotherapy in Cervical Cancer
Authors: Andrea Papadia, MD, PhD
Filippo Bellati, MD, PhD
Giorgio Bogani, MD
Antonino Ditto, MD
Fabio Martinelli, MD
Domenica Lorusso, MD
Cristina Donfrancesco, MD
Maria Luisa Gasparri, MD
Francesco Raspagliesi, MD
Publication date: 01-12-2015
Publisher: Springer US
Published in: Annals of Surgical Oncology / Issue Special Issue 3/2015
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-015-4799-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

When Does Neoadjuvant Chemotherapy Really Avoid Radiotherapy? Clinical Predictors of Adjuvant Radiotherapy in Cervical Cancer

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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