ArticleGynecologic oncology2021
Beyond Sedlis-A novel histology-specific nomogram for predicting cervical cancer recurrence risk: An NRG/GOG ancillary analysis.
Article in Gynecologic oncology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 32 papers, 1 of them a synthesis that pooled it.
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Who cites it
32 citing papers in PubMed, 1 synthesis or guideline pooled it, 58 citations in OpenAlex.
- Optimal adjuvant strategy in intermediate-risk cervical cancer: a systematic review and meta-analysis.International journal of clinical oncology · 2026Pooled it
- Chemoradiotherapy With or Without Simultaneous Integrated Boost for Cervical Cancer With Full-Thickness Stromal Invasion: A Phase 3 Randomized Clinical Trial.JAMA network open · 2025Trial
- Survival outcomes of postoperative radiotherapy and chemotherapy in early-stage cervical cancer: a Surveillance, Epidemiology, and End Results database-based stratified analysis.Translational cancer research · 2026Article
- Prognostic Survival Model Following Primary Radical Surgery for Early-Stage Cervical Cancer.Cancers · 2026Article
- Adjuvant Treatment for Surgically-Treated Cervical Cancer Patients: A Comprehensive Review.Cancers · 2025Review
- Prognostic value of risk factors in cervical squamous cell carcinoma based on tumour infiltration depth.BMC cancer · 2025Article
- Tumor Invasion Distance Based on MRI Is a Novel Prognostic Indicator for I-IIIB Cervical Cancer Patients Treated with Radiotherapy.Current oncology (Toronto, Ont.) · 2025Article
- Review
- ConvXGB: A novel deep learning model to predict recurrence risk of early-stage cervical cancer following surgery using multiparametric MRI images.Translational oncology · 2025Article
- Article
- Development and validation of prognostic prediction models for early-stage cervical cancer patients based on pathological intermediate-risk factors.Therapeutic advances in medical oncology · 2025Article
- Contemporary Review of Adenocarcinoma of the Cervix.Current treatment options in oncology · 2024Review
- Novel use of adjuvant proton beam therapy in patient with pelvic renal transplant diagnosed with stage IB3 cervical adenocarcinoma.Gynecologic oncology reports · 2024Article
- Establishment of a Novel Risk Stratification System Integrating Clinical and Pathological Parameters for Prognostication and Clinical Decision-Making in Early-Stage Cervical Cancer.Cancer medicine · 2024Article
- Screening and identification of susceptibility genes for cervical cancer via bioinformatics analysis and the construction of an mitophagy-related genes diagnostic model.Journal of cancer research and clinical oncology · 2024Article
- Review
- Cervical Cancer and Its Association With Pregnancy.Cureus · 2024Review
- Circulating cell-free HPV DNA is a strong marker for disease severity in cervical cancer.Molecular oncology · 2024Article
- A nomogram of preoperative indicators predicting lymph vascular space invasion in cervical cancer.Archives of gynecology and obstetrics · 2024Article
- The Association Between D-Dimer Levels and Recurrence in Patients with Early-Stage Cervical Cancer after Surgical Treatment.International journal of women's health · 2024Article
Corrections and comments
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Authors and funding
21 authors at 17 institutions in 2 countries.
Funding
Abstract
purposeThe Sedlis criteria define risk factors for recurrence warranting post-hysterectomy radiation for early-stage cervical cancer; however, these factors were defined for squamous cell carcinoma (SCC) at an estimated recurrence risk of ≥30%. Our study evaluates and compares risk factors for recurrence for cervical SCC compared with adenocarcinoma (AC) and develops histology-specific nomograms to estimate risk of recurrence and guide adjuvant treatment.
methodsWe performed an ancillary analysis of GOG 49, 92, and 141, and included stage I patients who were surgically managed and received no neoadjuvant/adjuvant therapy. Multivariable Cox proportional hazards models were used to evaluate independent risk factors for recurrence by histology and to generate prognostic histology-specific nomograms for 3-year recurrence risk.
resultsWe identified 715 patients with SCC and 105 with AC; 20% with SCC and 17% with AC recurred. For SCC, lymphvascular space invasion (LVSI: HR 1.58, CI 1.12-2.22), tumor size (TS ≥4 cm: HR 2.67, CI 1.67-4.29), and depth of invasion (DOI; middle 1/3, HR 4.31, CI 1.81-10.26; deep 1/3, HR 7.05, CI 2.99-16.64) were associated with recurrence. For AC, only TS ≥4 cm, was associated with recurrence (HR 4.69, CI 1.25-17.63). For both histologies, there was an interaction effect between TS and LVSI. For those with SCC, DOI was most associated with recurrence (16% risk); for AC, TS conferred a 15% risk with negative LVSI versus a 25% risk with positive LVSI.
conclusionsCurrent treatment standards are based on the Sedlis criteria, specifically derived from data on SCC. However, risk factors for recurrence differ for squamous cell and adenocarcinoma of the cervix. Histology-specific nomograms accurately and linearly represent risk of recurrence for both SCC and AC tumors and may provide a more contemporary and tailored tool for clinicians to base adjuvant treatment recommendations to their patients with cervical cancer.
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