ESTRO 2023 - Abstract Book

S486

Sunday 14 May 2023

ESTRO 2023

The data from multiple large prospective cohorts of molecularly classified endometrial cancers with robust long-term follow-up data yielded clinically relevant prediction models for vaginal, pelvic, distant, and overall recurrence and cancer- specific survival. These evidence-based models accurately estimate absolute risks and may support personalized predictions of the benefit of different adjuvant treatment strategies. The models will form the backbone of a mobile and web-based prediction tool that facilitates risk stratification and shared-decision making. OC-0603 Which is the optimal lymph node management in node positive cervical cancer? A. Zaharie 1 , A. Sturdza 1 , J. Knoth 1 , C. Grimm 2 , S. Polterauer 2 , C. Kirisits 1 , R. Pötter 1 , J. Widder 1 , M. Schmid 1 1 Medical University of Vienna, Radiation Oncology, Vienna, Austria; 2 Medical University of Vienna, Gynaecology, Vienna, Austria Purpose or Objective To analyze the impact of different lymph node (LN) management strategies on regional lymph node control (RNC) in patients with LN positive locally advanced cervical cancer (LACC) undergoing definitive chemoradiation (CRT) and image guided adaptive brachytherapy (IGABT). Materials and Methods All patients with pelvic and/or paraaortic nodal disease at diagnosis (FIGO stage IIIC1-2) treated at the Medical University of Vienna within the retrospective retroEMBRACE study and the prospective EMBRACE I and II studies were considered for analysis. Patients were stratified according to the respective LN management: (1) surgical staging (either as LN sampling and/or debulking = limited surgical staging; or as an extended lymphadenectomy = extended surgical staging) with complete resection of all suspicious LN disease followed by 45-50.4Gy CRT (surgery + CRT group); (2) 45-50.4Gy CRT + LN boost up to 60Gy without surgical staging (no surgery + CRT + boost); (3) 45-50.4Gy CRT without LN boost or surgical staging (no surgery + CRT); (4) incomplete surgical staging or remaining suspicious LN followed by 45-50.4Gy CRT with or without LN boost (combined treatment group). RNC was defined as the absence of pelvic and paraaortic LN recurrence at 3 years and was calculated using the Kaplan-Meier method by comparing LN management groups with log-rank tests. Results With a median follow-up of 40 months (IQR 12-88) 168 patients were available. Patient characteristics for the overall cohort and broken down by LN management group are shown in table 1. Overall, 3-year actuarial RNC was 77%. Three-year RNC per LN management group are displayed in figure 1). Surgical management followed by CRT showed a significantly improved in RNC compared to the CRT-only group (87% vs. 49%, p< 0,01), while an additional LN boost in suspicious LN at CRT seemed to also improve 3-year RNC (72% vs. 48%), albeit not reaching statistical significance (p=0,14). The type of surgical management had no significant impact on RNC (p=0,283).

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