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

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt

Standard

A federated approach to identify women with early-stage cervical cancer at low risk of lymph node metastases. / Wenzel, Hans H.B.; Hardie, Anna N.; Moncada-Torres, Arturo; Høgdall, Claus K.; Bekkers, Ruud L.M.; Falconer, Henrik; Jensen, Pernille T.; Nijman, Hans W.; van der Aa, Maaike A.; Martin, Frank; van Gestel, Anna J.; Lemmens, Valery E.P.P.; Dahm-Kähler, Pernilla; Alfonzo, Emilia; Persson, Jan; Ekdahl, Linnea; Salehi, Sahar; Frøding, Ligita P.; Markauskas, Algirdas; Fuglsang, Katrine; Schnack, Tine H.

I: European Journal of Cancer, Bind 185, 2023, s. 61-68.

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt

Harvard

Wenzel, HHB, Hardie, AN, Moncada-Torres, A, Høgdall, CK, Bekkers, RLM, Falconer, H, Jensen, PT, Nijman, HW, van der Aa, MA, Martin, F, van Gestel, AJ, Lemmens, VEPP, Dahm-Kähler, P, Alfonzo, E, Persson, J, Ekdahl, L, Salehi, S, Frøding, LP, Markauskas, A, Fuglsang, K & Schnack, TH 2023, 'A federated approach to identify women with early-stage cervical cancer at low risk of lymph node metastases', European Journal of Cancer, bind 185, s. 61-68. https://doi.org/10.1016/j.ejca.2023.02.021

APA

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., ... 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, 185, 61-68. https://doi.org/10.1016/j.ejca.2023.02.021

Vancouver

Wenzel HHB, Hardie AN, Moncada-Torres A, Høgdall CK, Bekkers RLM, Falconer H o.a. A federated approach to identify women with early-stage cervical cancer at low risk of lymph node metastases. European Journal of Cancer. 2023;185:61-68. https://doi.org/10.1016/j.ejca.2023.02.021

Author

Wenzel, Hans H.B. ; Hardie, Anna N. ; Moncada-Torres, Arturo ; Høgdall, Claus K. ; Bekkers, Ruud L.M. ; Falconer, Henrik ; Jensen, Pernille T. ; Nijman, Hans W. ; van der Aa, Maaike A. ; Martin, Frank ; van Gestel, Anna J. ; Lemmens, Valery E.P.P. ; Dahm-Kähler, Pernilla ; Alfonzo, Emilia ; Persson, Jan ; Ekdahl, Linnea ; Salehi, Sahar ; Frøding, Ligita P. ; Markauskas, Algirdas ; Fuglsang, Katrine ; Schnack, Tine H. / A federated approach to identify women with early-stage cervical cancer at low risk of lymph node metastases. I: European Journal of Cancer. 2023 ; Bind 185. s. 61-68.

Bibtex

@article{b8cc3673397c42c185191651141ac0aa,

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

abstract = "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.",

keywords = "Cervical cancer, Federated learning, Lymph node metastases, Risk factors",

author = "Wenzel, {Hans H.B.} and Hardie, {Anna N.} and Arturo Moncada-Torres and H{\o}gdall, {Claus K.} and Bekkers, {Ruud L.M.} and Henrik Falconer and Jensen, {Pernille T.} and Nijman, {Hans W.} and {van der Aa}, {Maaike A.} and Frank Martin and {van Gestel}, {Anna J.} and Lemmens, {Valery E.P.P.} and Pernilla Dahm-K{\"a}hler and Emilia Alfonzo and Jan Persson and Linnea Ekdahl and Sahar Salehi and Fr{\o}ding, {Ligita P.} and Algirdas Markauskas and Katrine Fuglsang and Schnack, {Tine H.}",

note = "Publisher Copyright: {\textcopyright} 2023 Elsevier Ltd",

year = "2023",

doi = "10.1016/j.ejca.2023.02.021",

language = "English",

volume = "185",

pages = "61--68",

journal = "European Journal of Cancer, Supplement",

issn = "0959-8049",

publisher = "Pergamon",

}

RIS

TY - JOUR

T1 - A federated approach to identify women with early-stage cervical cancer at low risk of lymph node metastases

AU - Wenzel, Hans H.B.

AU - Hardie, Anna N.

AU - Moncada-Torres, Arturo

AU - Høgdall, Claus K.

AU - Bekkers, Ruud L.M.

AU - Falconer, Henrik

AU - Jensen, Pernille T.

AU - Nijman, Hans W.

AU - van der Aa, Maaike A.

AU - Martin, Frank

AU - van Gestel, Anna J.

AU - Lemmens, Valery E.P.P.

AU - Dahm-Kähler, Pernilla

AU - Alfonzo, Emilia

AU - Persson, Jan

AU - Ekdahl, Linnea

AU - Salehi, Sahar

AU - Frøding, Ligita P.

AU - Markauskas, Algirdas

AU - Fuglsang, Katrine

AU - Schnack, Tine H.

PY - 2023

Y1 - 2023

N2 - 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.

AB - 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.

KW - Cervical cancer

KW - Federated learning

KW - Lymph node metastases

KW - Risk factors

U2 - 10.1016/j.ejca.2023.02.021

DO - 10.1016/j.ejca.2023.02.021

M3 - Journal article

C2 - 36965329

AN - SCOPUS:85151402189

VL - 185

SP - 61

EP - 68

JO - European Journal of Cancer, Supplement

JF - European Journal of Cancer, Supplement

SN - 0959-8049

ER -

ID: 366987715

Institut for Klinisk Medicin