Patterns of recurrence and prognosis in locally advanced FIGO stage IB2 to IIB cervical cancer: Retrospective multicentre study from the FRANCOGYN group

Tiphaine de Foucher (1, 2) , Sofiane Bendifallah (1, 2, 3) , Lobna Ouldamer (4, 5) , Alexandre Bricou (6) , Vincent Lavoué (7, 8) , Justine Varinot (1, 9) , Geoffroy Canlorbe (1, 2) , Xavier Carcopino (10, 11) , Emilie Raimond (12) , Laurie Monnier (1, 2) , Olivier Graesslin (12) , Cyril Touboul (13) , Pierre Collinet (14) , Marie-Emmanuelle Neveu (15) , Cyrille Huchon (16) , Emile Darai (16) , Marcos Ballester (1, 2, 17)

1 CHU Tenon [AP-HP]
2 IUC - Institut Universitaire de Cancérologie [Sorbonne Université]
3 DS3 - ESIM - Déterminants Sociaux de la Santé et du Recours aux Soins
4 CHU Trousseau [Tours]
5 Hôpital Bretonneau
6 Hôpitaux Universitaires de Paris Seine-Saint-Denis
7 Service de Gynécologie et Obstétrique [Rennes] = Gynaecology [Rennes]
8 CRLCC - CRLCC Eugène Marquis
9 UPMC - Université Pierre et Marie Curie - Paris 6
10 Service de gynécologie-obstétrique [Hôpital Nord - APHM]
11 IRD Marseille - Institut de Recherche pour le Développement (IRD) Marseille
12 Hôpital universitaire Robert Debré [Reims]
13 CHIC - Centre Hospitalier Intercommunal de Créteil
14 Hôpital Jeanne de Flandre [Lille]
15 Hôpital Bicêtre [AP-HP, Le Kremlin-Bicêtre]
16 Service de gynécologie et obstétrique [CHI Poissy-Saint Germain]
17 CRSA - Centre de Recherche Saint-Antoine

IntroductionEvidence-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 methodsData of women with FIGO stage IB2 to IIB CC treated between April 1996 and May 2016 were retrospectively abstracted from nine French institutions.ResultsThe 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.ConclusionsRecurrence 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.

Mots clés: Locally advanced cervical cancer; Pattern; Recurrence; Survival

Domaines: Cancer; Santé; Gynécologie et obstétrique

Tiphaine de Foucher, Sofiane Bendifallah, Lobna Ouldamer, Alexandre Bricou, Vincent Lavoué, et al.. Patterns of recurrence and prognosis in locally advanced FIGO stage IB2 to IIB cervical cancer: Retrospective multicentre study from the FRANCOGYN group. EJSO - European Journal of Surgical Oncology, 2019, 45 (4), pp.659-665. ⟨10.1016/j.ejso.2018.11.014⟩. ⟨hal-02468510⟩