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  • Wenzel, H. H. B.University Medical Center Groningen,Netherlands Comprehensive Cancer Organisation (IKNL) (author)

A federated approach to identify women with early-stage cervical cancer at low risk of lymph node metastases

  • Article/chapterEnglish2023

Publisher, publication year, extent ...

  • Elsevier BV,2023

Numbers

  • LIBRIS-ID:oai:gup.ub.gu.se/330768
  • https://gup.ub.gu.se/publication/330768URI
  • https://doi.org/10.1016/j.ejca.2023.02.021DOI
  • http://kipublications.ki.se/Default.aspx?queryparsed=id:153315869URI
  • https://lup.lub.lu.se/record/f71357f7-3b7c-4fa3-af1a-f76009efe00aURI

Supplementary language notes

  • Language:English

Part of subdatabase

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  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • Objective: Lymph node metastases (pN+) in presumed early-stage cervical cancer negatively impact prognosis. Using federated learning, we aimed to develop a tool to identify a group of women at low risk of pN+, to guide the shared decision-making process concerning the extent of lymph node dissection.Methods: Women with cervical cancer between 2005 and 2020 were identified retrospectively from population-based registries: the Danish Gynaecological Cancer Database, Swedish Quality Registry for Gynaecologic Cancer and Netherlands Cancer Registry. Inclusion cri-teria were: squamous cell carcinoma, adenocarcinoma or adenosquamous carcinoma; The International Federation of Gynecology and Obstetrics 2009 IA2, IB1 and IIA1; treatment with radical hysterectomy and pelvic lymph node assessment. We applied privacy-preserving federated logistic regression to identify risk factors of pN+. Significant factors were used to stratify the risk of pN+. Results: We included 3606 women (pN+ 11%). The most important risk factors of pN+ were lymphovascular space invasion (LVSI) (odds ratio [OR] 5.16, 95% confidence interval [CI], 4.59-5.79), tumour size 21-40 mm (OR 2.14, 95% CI, 1.89-2.43) and depth of invasion > 10 mm (OR 1.81, 95% CI, 1.59-2.08). A group of 1469 women (41%)-with tumours without LVSI, tumour size 520 mm, and depth of invasion 510 mm-had a very low risk of pN + (2.4%, 95% CI, 1.7-3.3%). Conclusion: Early-stage cervical cancer without LVSI, a tumour size 520 mm and depth of invasion 510 mm, confers a low risk of pN+. Based on an international privacy-preserving analysis, we developed a useful tool to guide the shared decision-making process regarding lymph node dissection.& COPY; 2023 Elsevier Ltd. All rights reserved.

Subject headings and genre

Added entries (persons, corporate bodies, meetings, titles ...)

  • Hardie, A. N.Karolinska Institutet,Karolinska University Hospital (author)
  • Moncada-Torres, A.Netherlands Comprehensive Cancer Organisation (IKNL) (author)
  • Hogdall, C. K.University of Copenhagen (author)
  • Bekkers, R. L. M.Maastricht University,Catharina Hospital (author)
  • Falconer, H.Karolinska Institutet,Karolinska University Hospital (author)
  • Jensen, P. T.University of Southern Denmark,Aarhus University Hospital (author)
  • Nijman, H. W.University Medical Center Groningen (author)
  • van der Aa, M. A.Netherlands Comprehensive Cancer Organisation (IKNL),Odense University Hospital (author)
  • Martin, F.Netherlands Comprehensive Cancer Organisation (IKNL) (author)
  • van Gestel, A. J.Netherlands Comprehensive Cancer Organisation (IKNL) (author)
  • Lemmens, Vepp (author)
  • Dahm-Kähler, Pernilla,1964Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för obstetrik och gynekologi,Institute of Clinical Sciences, Department of Obstetrics and Gynecology,Sahlgrenska University Hospital(Swepub:gu)xdahmp (author)
  • Alfonzo, EmiliaGothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för obstetrik och gynekologi,Institute of Clinical Sciences, Department of Obstetrics and Gynecology,Sahlgrenska University Hospital(Swepub:gu)xalfem (author)
  • Persson, JanLund University,Lunds universitet,Obstetrik och gynekologi, Lund,Sektion V,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Livmoder och livmoderhalscancer,Forskargrupper vid Lunds universitet,Obstetrics and Gynaecology (Lund),Section V,Department of Clinical Sciences, Lund,Faculty of Medicine,Endometrial and cervical cancer,Lund University Research Groups(Swepub:lu)gyn-jpe (author)
  • Ekdahl, LinneaLund University,Lunds universitet,Livmoder och livmoderhalscancer,Forskargrupper vid Lunds universitet,Endometrial and cervical cancer,Lund University Research Groups,Skåne University Hospital(Swepub:lu)li6714ek (author)
  • Salehi, S.Karolinska Institutet,Karolinska University Hospital (author)
  • Froding, L. P.Copenhagen University Hospital (author)
  • Markauskas, A. (author)
  • Fuglsang, K.Aarhus University Hospital (author)
  • Schnack, T. H.University of Copenhagen,Odense University Hospital (author)
  • University Medical Center GroningenNetherlands Comprehensive Cancer Organisation (IKNL) (creator_code:org_t)

Related titles

  • In:European Journal of Cancer: Elsevier BV185, s. 61-680959-80491879-0852

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