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

التفاصيل البيبلوغرافية
العنوان: A federated approach to identify women with early-stage cervical cancer at low risk of lymph node metastases
المؤلفون: Hans H.B. Wenzel, Anna N. Hardie, Arturo Moncada-Torres, Claus K. Høgdall, Ruud L.M. Bekkers, Henrik Falconer, Pernille T. Jensen, Hans W. Nijman, Maaike A. van der Aa, Frank Martin, Anna J. van Gestel, Valery E.P.P. Lemmens, Pernilla Dahm-Kähler, Emilia Alfonzo, Jan Persson, Linnea Ekdahl, Sahar Salehi, Ligita P. Frøding, Algirdas Markauskas, Katrine Fuglsang, Tine H. Schnack
المساهمون: Public Health
المصدر: Wenzel, H H B, Hardie, A N, Moncada-Torres, A, Høgdall, C K, Bekkers, R L M, Falconer, H, Jensen, P T, Nijman, H W, van der Aa, M A, Martin, F, van Gestel, A J, Lemmens, V E P P, Dahm-Kähler, P, Alfonzo, E, Persson, J, Ekdahl, L, Salehi, S, Frøding, L P, Markauskas, A, Fuglsang, K & Schnack, T H 2023, ' A federated approach to identify women with early-stage cervical cancer at low risk of lymph node metastases ', European Journal of Cancer, vol. 185, pp. 61-68 . https://doi.org/10.1016/j.ejca.2023.02.021
European Journal of Cancer, 185, 61-68. Elsevier Ltd.
سنة النشر: 2023
مصطلحات موضوعية: Uterine Cervical Neoplasms/surgery, Cancer Research, Federated learning, Hysterectomy, Lymph Nodes/surgery, SDG 3 - Good Health and Well-being, Oncology, Risk factors, Lymphatic Metastasis/pathology, Cervical cancer, Humans, Lymph Node Excision, Female, Lymph node metastases, Retrospective Studies, Neoplasm Staging
الوصف: 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 criteria 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 ≤20 mm, and depth of invasion ≤10 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 ≤20 mm and depth of invasion ≤10 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.
اللغة: English
تدمد: 0959-8049
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::7f3a5ae0ef636bab7530ed4548aab730
https://pure.au.dk/portal/da/publications/a-federated-approach-to-identify-women-with-earlystage-cervical-cancer-at-low-risk-of-lymph-node-metastases(53222236-a198-489c-a4ac-d5c1c2947e6d).html
حقوق: OPEN
رقم الأكسشن: edsair.doi.dedup.....7f3a5ae0ef636bab7530ed4548aab730
قاعدة البيانات: OpenAIRE
الوصف
تدمد:09598049