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A validation study of new risk grouping criteria for postoperative treatment in stage IB cervical cancers without high-risk factors: rethinking the Gynecologic Oncology Group criteria.

Authors
Chang, SJ; Kim, WY; Yoo, SC; Yoon, JH; Chun, M; Chang, KH; Ryu, HS
Citation
European journal of obstetrics, gynecology, and reproductive biology, 147(1):91-96, 2009
Journal Title
European journal of obstetrics, gynecology, and reproductive biology
ISSN
0301-21151872-7654
Abstract
OBJECTIVE: The aim of this study was to verify whether the Gynecologic Oncology Group (GOG) criteria are valid in a different cohort of patients and to investigate simplified new criteria tailoring adjuvant radiation therapy in patients with intermediate-risk factors after radical hysterectomy.



STUDY DESIGN: We analyzed the data of 332 patients with FIGO stage IB cervical cancer who underwent radical hysterectomy between 1994 and 2007. Two hundred and twenty-five patients without high-risk factors (lymph node metastasis, parametrial invasion, or positive surgical margins) were identified and were classified into low-risk and high-risk groups according to the GOG criteria and new criteria based on combinations of intermediate-risk factors (large tumor size, deep stromal invasion, lymph-vascular space invasion). We evaluated the prognostic significance of both criteria.



RESULTS: We identified 140 low-risk patients and 85 high-risk patients in the application of the GOG criteria. Low-risk patients had significantly better disease-free survival (DFS) (P=0.001) and overall survival (OS) (P=0.013) than high-risk patients. There were 145 low-risk patients and 80 high-risk patients on applying the new criteria. Low-risk patients had significantly better DFS (P=0.001) and OS (P=0.013) than high-risk patients. The receiver operating characteristic (ROC) curves showed that both criteria had similar performance for predicting which patients would have help from adjuvant therapy.



CONCLUSION: This study demonstrated that the GOG criteria were still valid in the different population, the simplified new criteria were convenient to apply in practice, and the performance of the new criteria was as good as the GOGs.
MeSH terms
AdultAgedCohort StudiesCombined Modality TherapyDisease-Free SurvivalFemaleHumansHysterectomyMiddle AgedNeoplasm StagingPostoperative Care/methods*PrognosisROC CurveRadiotherapy, Adjuvant*Retrospective StudiesRisk FactorsUterine Cervical Neoplasms/diagnosisUterine Cervical Neoplasms/pathology*Uterine Cervical Neoplasms/therapy*
DOI
10.1016/j.ejogrb.2009.07.013
PMID
19695765
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Obstetrics & Gynecology
Journal Papers > School of Medicine / Graduate School of Medicine > Radiation Oncology
Journal Papers > School of Medicine / Graduate School of Medicine > Medical Science
AJOU Authors
장, 석준김, 우영유, 승철윤, 종혁전, 미선장, 기홍유, 희석
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