Lee, Jung-Yun; Youm, Jina; Kim, Tae Hun; Cho, Jeong Yeon; Kim, Min A; Suh, Dong Hoon; Lim, Myong Cheol; Kim, Jae-Weon; Park, Noh Hyun; Song, Yong-Sang
Gynecologic oncology
2014Jul ; 134 ( 1 ) :47-51.
PMID : 24768849
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Lee, Jung-Yun - Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Republic of Korea.
Youm, Jina - Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Republic of Korea.
Kim, Tae Hun - Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Republic of Korea.
Cho, Jeong Yeon - Department of Radiology, Seoul National University College of Medicine, Seoul, Republic of Korea.
Kim, Min A - Department of Pathology, Seoul National University College of Medicine, Seoul, Republic of Korea.
Suh, Dong Hoon - Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea.
Lim, Myong Cheol - Center for Uterine Cancer, National Cancer Center, Goyang, Gyeonggi-do, Republic of Korea.
Kim, Jae-Weon - Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Republic of Korea. Electronic address kjwksh@snu.ac.kr.
Park, Noh Hyun - Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Republic of Korea.
Song, Yong-Sang - Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Republic of Korea.
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 ??5 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. CI - Copyright ??2014 Elsevier Inc. All rights reserved.
keyword
Cervical cancer; Less radical surgery; Magnetic resonance imaging; Parametrial involvement; Tumor diameter
MESH
Adult, Aged, Female, Humans, Hysterectomy, Lymph Node Excision, Magnetic Resonance Imaging/methods, Middle Aged, Neoplasm Staging, Preoperative Care, Retrospective Studies, Risk Factors, Uterine Cervical Neoplasms/*pathology/*surgery
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