Jung-Yun Lee1, Jina Youm1, Tae Hun Kim1, Jeong Yeon Cho2, Min A Kim3, Dong Hoon Suh4, Myong Cheol Lim5, Jae-Weon Kim6, Noh Hyun Park1, Yong-Sang Song1. 1. Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Republic of Korea. 2. Department of Radiology, Seoul National University College of Medicine, Seoul, Republic of Korea. 3. Department of Pathology, Seoul National University College of Medicine, Seoul, Republic of Korea. 4. Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea. 5. Center for Uterine Cancer, National Cancer Center, Goyang, Gyeonggi-do, Republic of Korea. 6. Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Republic of Korea. Electronic address: kjwksh@snu.ac.kr.
Abstract
OBJECTIVE: The aim of this study is to identify a patient group with a low-risk of parametrial involvement (PMI) in Stage IB1 cervical cancer using preoperative magnetic resonance imaging (MRI) parameters. METHODS: In total, 190 Stage IB1 cervical cancer patients with clinically visible lesions who had undergone Type C2 radical hysterectomy and preoperative MRI were included in this study. Clinical records, pathology reports, and preoperative MRI findings were reviewed retrospectively. RESULTS: Of the 190 patients, 19 (10%) had pathologic PMI. The largest tumor diameter identified by MRI ranged from zero (no definite mass on the cervix) to 60 mm, with a median of 21 mm. Patients were identified as being either low-risk (tumor size ≤25 mm and no evidence of PMI, n=127) or high-risk (tumor size >25 mm and/or findings indicating PMI, n=63) based on MRI parameters. The rate of pathologic PMI in low- and high-risk patients was 0.0% and 30.2%, respectively (P<0.001). Five-year progression-free survival in low-risk patients was 95.9%, which is significantly better than the rate of 85.6% for patients in the high-risk group (P=0.039). CONCLUSIONS: Preoperative MRI parameters can help identify patients with a low-risk of PMI and, therefore, possible candidates for trials on less radical surgery.
OBJECTIVE: The aim of this study is to identify a patient group with a low-risk of parametrial involvement (PMI) in Stage IB1 cervical cancer using preoperative magnetic resonance imaging (MRI) parameters. METHODS: In total, 190 Stage IB1 cervical cancerpatients with clinically visible lesions who had undergone Type C2 radical hysterectomy and preoperative MRI were included in this study. Clinical records, pathology reports, and preoperative MRI findings were reviewed retrospectively. RESULTS: Of the 190 patients, 19 (10%) had pathologic PMI. The largest tumor diameter identified by MRI ranged from zero (no definite mass on the cervix) to 60 mm, with a median of 21 mm. Patients were identified as being either low-risk (tumor size ≤25 mm and no evidence of PMI, n=127) or high-risk (tumor size >25 mm and/or findings indicating PMI, n=63) based on MRI parameters. The rate of pathologic PMI in low- and high-risk patients was 0.0% and 30.2%, respectively (P<0.001). Five-year progression-free survival in low-risk patients was 95.9%, which is significantly better than the rate of 85.6% for patients in the high-risk group (P=0.039). CONCLUSIONS: Preoperative MRI parameters can help identify patients with a low-risk of PMI and, therefore, possible candidates for trials on less radical surgery.
Authors: Jung-Yun Lee; Jina Youm; Jae Weon Kim; Kidong Kim; Hak Jae Kim; Jeong Yeon Cho; Min A Kim; Noh Hyun Park; Yong-Sang Song Journal: Cancer Res Treat Date: 2015-03-20 Impact factor: 4.679