Patterns of recurrence and prognosis in locally advanced FIGO stage IB2 to IIB cervical cancer: Retrospective multicentre study from the FRANCOGYN group.
de Foucher Tiphaine,Bendifallah Sofiane,Ouldamer Lobna,Bricou Alexandre,Lavoue Vincent,Varinot Justine,Canlorbe Geoffroy,Carcopino Xavier,Raimond Emilie,Monnier Laurie,Graesslin Olivier,Touboul Cyril,Collinet Pierre,Neveu Marie-Emmanuelle,Huchon Cyrille,Daraï Emile,Ballester Marcos,
European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
INTRODUCTION:Evidence-based data describing patterns of recurrence and prognosis in women with FIGO stage IB2 to IIB locally advanced cervical cancer (LACC) are scarce. The purpose of this study was to analyse patterns of recurrence in LACC and their correlation with prognosis, depending on FIGO stage, lymph node (LN) status and treatment modalities. The endpoints of this study were the type of recurrence (locoregional or distant, and time to recurrence), the recurrence free survival, the overall survival and the cumulative incidence for both locoregional and distant recurrence. MATERIALS AND METHODS:Data of women with FIGO stage IB2 to IIB CC treated between April 1996 and May 2016 were retrospectively abstracted from nine French institutions. RESULTS:The median follow-up for the 501 women included was 35.6 months. Recurrences were observed in 158 (31.5%), with a mean time to recurrence of 20.7 months. Women with IIB CC had poorer prognosis, lower 3-year RFS and higher 3-year cumulative incidence of both locoregional and distant recurrences. Women with positive or unknown LN status had poorer prognosis with higher 3-year cumulative incidence of distant recurrence. Women who underwent concomitant chemo-radiotherapy ± vaginal brachytherapy had poorer prognosis, with lower 3-year RFS and higher 3-year cumulative incidence of distant recurrence. CONCLUSIONS:Recurrence location and time to recurrence differ widely depending on the FIGO stage, LN status and treatment modalities, with potential impact on follow-up modalities and therapeutic approaches.