Retrospective analysis of prognosis using the Gynecology Oncology Group score of stage IB‑IIA node negative uterine cervical cancer after radical hysterectomy and trachelectomy

Abstract

There is currently controversy regarding the criteria for low and intermediate risk of cervical cancer (CC) after surgery. In the present study, the Gynecology Oncology Group (GOG) score was used to detect intermediate risk. Adjuvant radiotherapy was applied in the case of a GOG score >120. The present study aimed to evaluate the validity of the recurrence risk classification using the GOG score for stage IB-IIA node-negative CC. All cases of stage IB-IIA node-negative CC who underwent radical surgery between February 2007 and December 2015 were retrospectively reviewed. The GOG scores were determined from clinical and pathological findings and accordingly, subjects were divided into 4 groups: A, ≤40; B, >40 and ≤70; C, >70 and ≤120; and D, >120. Overall survival (OS) and recurrence-free survival (RFS) curves were generated using the Kaplan-Meier method. The log-rank test produced an estimated P-value by comparing the OS and RFS of group A (low-score group) with those of others. The present study included 61 patients (mean age, 47.82 years; age range, 22-76 years) and the median follow-up was 79 (39-149) months. Of these, 60 patients were observed for at least 60 months. During the follow-up period, the OS and RFS rates of group C were 94.7 and 84.2%, respectively, while those of group D were 100 and 91.7%, respectively; the OS and RFS of groups A and B were 100%. Log-rank tests for all OS and RFS indicated no significant differences compared to group A. It was indicated that a GOG score ≤70 does not require adjuvant therapy; however, a GOG score >70 requires consideration of adjuvant therapy based on the risk factors which constitute the score.

Pneumovaginoscopy-assisted radical hysterectomy for early-stage cervical cancer: a novel bidirectional approach for tumor spillage prevention and R0 resection

“…However, this approach has a risk of tumor spillage, and its use is being phased out in Europe for this reason. Loose closure has been suggested as the cause [ 14 15 ]. Therefore, we used barbed sutures during vaginal cuff creation to ensure the sutures did not loosen.…”

Systematic Review—Role of MRI in Cervical Cancer Staging

“…These factors have been shown to be independent prognostic factors for a 3-year disease free interval in patients with cervical cancer [ 17 ]. This has been used by many institutions, and it has been shown that patients with a GOG score <70 are associated with good recurrence-free survival without adjuvant therapy [ 18 ]. However, patients with a GOG score >120 have a 41% risk of recurrence without adjuvant therapy after radical hysterectomy and the standard of care for patients with a GOG score between 70 and 120 is less clear [ 18 , 19 ].…”