Early Invasive Cervical Cancer: Tumor Delineation by Magnetic Resonance Imaging, Computed Tomography, and Clinical Examination, Verified by Pathologic Results, in the ACRIN 6651/GOG 183 Intergroup Study

Mitchell, Donald G.; Snyder, Bradley S.; Coakley, Fergus V.; Reinhold, Caroline; Thomas, Gillian; Amendola, Marco A.; Schwartz, Lawrence H.; Woodward, Paula J.; Pannu, Harpreet K.; Hricak, Hedvig

doi:10.1200/jco.2006.07.4799

Cited by 277 publications

(161 citation statements)

References 56 publications

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“…In studies by Hricak et al and Mitchell et al, in locally advanced cervical cancers, imaging modalities were superior for staging purposes (Hricak et al, 2005;Mitchell et al, 2006;Shirazi et al, 2014). In contrast, clinical staging was found to be more effective in a study by Hancke et al (Hancke et al, 2008).…”

Section: Discussionmentioning

confidence: 88%

Effect of Hydronephrosis on Survival in Advanced Stage Cervical Cancer

Goklu

Seçkin²,

Toğrul³

et al. 2015

Asian Pacific Journal of Cancer Prevention

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Background: Hydronephrosis is frequently encountered in advanced stage cervical cancers, and may be associated with mortality. In the present study, we aimed to demonstrate the effect of hydronephrosis on survival in patients with inoperable advanced stage cervical cancer. Materials and Methods: The study data were acquired by retrospective analysis of the patient records belonging to 165 women with FIGO (International Federation of Gynecology and Obstetrics) stage-IIIB or more advanced cervical cancer, which were not surgical candidates. Parameters including patient age, pathological diagnosis, disease stage, pelvic sidewall extension, presence of hydronephrosis and administration of chemoradiation were analyzed. Further, the effects of these variables on survival were assessed. P values less than 0.05 were considered statistically significant. Results: The distribution of the study patients according to disease stage was as follows: 131 (79.4%) had stage-IIIB, 18 (10.9%) had stage-IVB and 16 (% 9.7) patients had stage-IVA disease. Hydronephrosis was not evident in 91 (55.2%) of these patients, whereas 41 (24.8%) had unilateral and 33 (20%) patients had bilateral hydronephrosis. When compared to mean survival in patients who did not have hydronephrosis, survival was significantly shortened in patients who had bilateral and unilateral hydronephrosis (p < 0.05). There was no significant survival difference between patients with unilateral and bilateral hydronephrosis (p>0.05). Although patient age, pathological type, pelvic involvement, and chemotherapy treatment rates were similar (p>0.05), radiotherapy requirement rate and disease stage were significantly different among the study groups (p<0.05). Conclusions: Hydronephrosis was found to be a significant predictor of poor survival in patients with advanced stage cervical cancer, irrespective of unilateral or bilateral involvement.While waiting for future studies with larger sample sizes, we believe that the FIGO stages in advanced cervical cancer could further be stratified into subgroups according to presence or absence of hydronephrosis.

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Section: Discussionmentioning

confidence: 88%

Effect of Hydronephrosis on Survival in Advanced Stage Cervical Cancer

Goklu

Seçkin²,

Toğrul³

et al. 2015

Asian Pacific Journal of Cancer Prevention

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“…As the American College of Radiology Imaging Network (ACRIN )6651/GOG 183 Intergroup study showed [5], current MRI technology delineates tumour boundaries accurately and is frequently used to guide both treatment development and application [3,4]. In particular, MRI …”

Section: Discussionmentioning

confidence: 99%

“…Evidence suggests that MRI may predict the extent of disease more accurately than clinical staging [5]. With regard to bladder invasion, studies specifically tested the diagnostic accuracy of MRI against cystoscopic examination and/or surgical sampling as reference standards [6][7][8][9][10].…”

mentioning

confidence: 99%

Prognostic significance of MRI-detected bladder muscle and/or serosal invasion in patients with cervical cancer treated with radiotherapy

Nam

Huh²,

Park³

et al. 2010

British Journal of Radiology

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ABSTRACT. In cervical cancer, the prognostic significance of bladder wall invasion on MRI without pathological evidence of mucosal invasion is not known. From 454 consecutive patients with cervical cancer who were treated with radiation, we reviewed images and analysed the outcome of 92 patients with the Federation of International Gynecology and Obstetrics (FIGO) stage IIIB-IVA. We analysed the patients in three groups, normal, wall (muscle and/or serosal) invasion and mucosal invasion, according to the findings on the MRI. Kaplan-Meier life table analysis and the log-rank test were used to assess the survival rates and differences according to prognostic factors. MRI detected abnormalities in the bladder wall in 42 patients (45.6%): wall invasion in 24 and mucosal invasion in 18. 5 of 18 patients, suspected on MRI to have mucosal invasion, showed no pathological evidence of mucosal invasion. Median follow-up period was 34 months. 3-year cause-specific survival (CSS) in the normal group compared with the wall invasion group was 76.2% vs 71.4% (p50.48). 3-year CSS for the wall invasion group compared with the mucosal invasion group was 71.4% vs 54.3% (p50.04). Mucosal invasion on MRI (p50.03) and concurrent chemoradiotherapy (p50.01) was significant for CSS. The prognosis for patients with cervical cancer with evidence of muscle and/or serosal invasion of the bladder on MRI may not differ from that for patients without abnormality on MRI. In patients with the MRI finding of bladder mucosal invasion, further studies should be conducted regarding the role of cystoscopy to determine the need for pathological confirmation.

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“…In the staging evaluation of cervical cancer, CT and MR imaging are generally equivalent for the assessment of lymph node and metastatic involvement, but MR imaging is superior in delineating tumor extent within the uterus and direct extensions of tumor to adjacent pelvic tissues (19,20), including bladder invasion, parametrial extension, and rectal and perirectal involvement. Ancillary findings that may or may not be related to the tumor but can influence the treatment approach, such as distortion or retroversion of the uterus, uterine fibroids, ovarian findings, and other pelvic abnormalities, can be readily evaluated with MR imaging.…”

Section: Mr Imagingmentioning

confidence: 99%

Imaging across the Life Span: Innovations in Imaging and Therapy for Gynecologic Cancer

Xu‐Welliver¹,

Yuh²,

Macura

et al. 2014

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The focus of this article is radiation therapy for gynecologic cancers, with emphasis on imaging-based treatment planning and delivery. For the various gynecologic cancers, radiation oncologists rely on essential clinical information to triage treatment options, and various imaging studies are performed for treatment planning and radiation therapy delivery. A practical approach is provided to help radiologists tailor their reports for the needs of their radiation oncology and gynecologic oncology colleagues, to optimize multidisciplinary care for patients with gynecologic cancer. Template radiology reports are proposed to address the specific information needs of oncologists at each phase-before, during, and after treatment. Fueled by the rapid progress in engineering and computer sciences during the past 2 decades, remarkable advances have been made in anatomic, functional, and molecular imaging and in radiation treatment planning and delivery in patients with gynecologic cancer. Radiation therapy has evolved from a nontargeted approach to a precisely targeted, highly conformal treatment modality, to further improve treatment outcomes and reduce morbidity. Highquality imaging has become essential for staging of the disease, delineation of tumor extent for treatment planning and delivery, and monitoring therapy response. Anatomic and functional imaging has also been shown to provide prognostic information that allows clinicians to tailor therapy on the basis of personalized patient information. This field is an area of active research, and future clinical trials are warranted to validate preliminary results in the field.

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Early Invasive Cervical Cancer: Tumor Delineation by Magnetic Resonance Imaging, Computed Tomography, and Clinical Examination, Verified by Pathologic Results, in the ACRIN 6651/GOG 183 Intergroup Study

Abstract: In patients with cervical cancer, MRI is superior to CT and clinical examination for evaluating uterine body involvement and measuring tumor size, but no method was accurate for evaluating cervical stroma.

Cited by 277 publications

References 56 publications

Effect of Hydronephrosis on Survival in Advanced Stage Cervical Cancer

Effect of Hydronephrosis on Survival in Advanced Stage Cervical Cancer

Prognostic significance of MRI-detected bladder muscle and/or serosal invasion in patients with cervical cancer treated with radiotherapy

Imaging across the Life Span: Innovations in Imaging and Therapy for Gynecologic Cancer

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