Early stage cervical cancer: role of magnetic resonance imaging after conization in determining residual tumor

Woo, Sungmin; Kim, Hye Sung; Chung, Hyun Hoon; Kim, Sang-Youn; Kim, Seung Hyup; Cho, Jeong Yeon

doi:10.1177/0284185115620948

Cited by 11 publications

(14 citation statements)

References 33 publications

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“…As a result, the panel uses the FIGO definitions as the stratification system for these guidelines, although the findings on imaging studies (ie, CT, MRI, PET/CT) are used to guide treatment options and design. MRI is useful to delineate disease extent and to guide decisions regarding fertility-sparing versus non-fertility-sparing treatment approaches, [15][16][17][18][19][20][21] whereas PET/CT may be useful to detect and/or rule out metastasis. [22][23][24][25][26]…”

Section: Clinical Stagingmentioning

confidence: 99%

Cervical Cancer, Version 3.2019, NCCN Clinical Practice Guidelines in Oncology

Koh¹,

Abu‐Rustum²,

Bean³

et al. 2019

J Natl Compr Canc Netw

815

638

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Cervical cancer is a malignant epithelial tumor that forms in the uterine cervix. Most cases of cervical cancer are preventable through human papilloma virus (HPV) vaccination, routine screening, and treatment of precancerous lesions. However, due to inadequate screening protocols in many regions of the world, cervical cancer remains the fourth-most common cancer in women globally. The complete NCCN Guidelines for Cervical Cancer provide recommendations for the diagnosis, evaluation, and treatment of cervical cancer. This manuscript discusses guiding principles for the workup, staging, and treatment of early stage and locally advanced cervical cancer, as well as evidence for these recommendations. For recommendations regarding treatment of recurrent or metastatic disease, please see the full guidelines on NCCN.org.

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Section: Clinical Stagingmentioning

confidence: 99%

Cervical Cancer, Version 3.2019, NCCN Clinical Practice Guidelines in Oncology

Koh¹,

Abu‐Rustum²,

Bean³

et al. 2019

J Natl Compr Canc Netw

815

638

View full text Add to dashboard Cite

show abstract

“…In a fourth patient, conisation probably caused the difference in tumour size (Fig. A2), since tumour measurement on MRI after conisation might be less reliable [21]. Another cause of measurement inaccuracy is shrinkage of the tumour during fixation (generally 10% in any direction), whereas on MRI the size remains unaffected [22].…”

Section: Discussionmentioning

confidence: 99%

Prospective validation of craniocaudal tumour size on MR imaging compared to histoPAthology in patients with uterine cervical cancer: The MPAC study

Boer

Spijkerboer

Bleeker

et al. 2019

Clinical and Translational Radiation Oncology

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To determine the accuracy of MRI in detecting craniocaudal tumour extension, compared to histopathology, of the hysterectomy specimen in patients with early-stage uterine cervical cancer. Three complementary methods were investigated. Materials and methods: Thirty-four patients with early-stage cervical cancer had pre-operative MRI, followed by radical hysterectomy or trachelectomy. 1) craniocaudal tumour extension was measured on MRI by two radiologists and compared to microscopy by a pathologist, 2) to compensate for changes in uterine shape between pre-operative MRI and the surgical specimen, craniocaudal tumour extensions were directly compared and appreciated as being a part of a 3-dimensional tumour by a radiation oncologist and resident, and 3) tumour size on MRI was compared macroscopically after digital non-rigid registration of the uterus, uterine cavity and tumour of both modalities. Results: The craniocaudal tumour extension measured on histopathology minus MRI gives: 1) on average +3 mm difference when measured by a radiologist compared to the microscopic extension (range À13 to +15 mm), 2) À0.2 mm (range À11 to +6.0 mm) when evaluated on MRI by a radiation oncologist compared to the macroscopic tumour; 3) after non-rigid organ registration, a margin of 10 mm around the tumour on MRI would be needed to cover 95% of the tumour in 90% of the patients. Conclusions: Results indicate that microscopic tumour extension towards the uterine fundus is within a margin of 10 mm around the visible tumour on MRI. The major source of measurement uncertainty is post-surgical change of organ shape and form.

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“…10.50 Volumetry with MRI can estimate tumor size and volume. 28,51 MRI can also be used to estimate the range of stromal infiltration and extent of unaffected stroma. 8 Most authors suggest simple trachelectomy for those with low-risk histologic types (adenosquamous, adenocarcinoma, and squamous).…”

Section: Simple Trachelectomymentioning

confidence: 99%

“…In patients with high-risk histology (sarcoma, neuroendocrine, and serous), the impact of lower radicality on patient's prognosis is not well established. [49][50][51][52] Positron emission tomography/computed tomography (PET-CT) scans can be used for lymph nodes evaluation preoperatively. 8 Compared to MRI, PET-CT scans have better sensitivity and specificity (75% vs 56%; 98% vs. 93%).…”

Section: Simple Trachelectomymentioning

confidence: 99%

Fertility-Sparing Surgery In Early Stage Cervical Cancer

Budiana

Pemayun

2018

Indonesian Journal of Cancer

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Cervical cancer is a malignancy in women that cause major impacts, not only biologically, but also in various aspects of life. On patients during reproductive age, cervical cancer poses severe sexual and reproductive debilitation. Trend in the onset of first diagnosis is moving towards younger age, and mostly affect women in their reproductive age. This would give a bad impact on the sustainability of the patient’s reproductive function. Until now, fertilitysparing approach for the management of early-stage cervical cancer is still rare in Indonesia. However, some options of conservative surgical therapy are available for patients who desire fertility, namely conization, simple tracellectomy, radical trachelectomy, and also neoadjuvant chemotherapy. These options have been proven effective and safe, while maintaining patients’ reproductive functions. ABSTRAKKanker serviks merupakan suatu penyakit keganasan pada wanita yang memiliki dampak luas, tidak hanya pada tubuh penderita, namun juga berbagai aspek kehidupan penderita. Pada penderita di usia reproduktif, kanker serviks menimbulkan masalah seksual dan reproduksi yang berat bagi penderita. Kini usia dimana terjadinya kanker serviks mulai menunjukkan kecenderungan yang semakin muda yang tentunya memberikan dampak buruk terhadap keberlangsungan fungsi reproduksi pasien. Hingga saat ini, tatalaksana kanker serviks stadium awal dengan pendekatan fertility-sparing masih jarang dilakukan di Indonesia. Namun, beberapa pilihan terapi bedah konservatif tersedia bagi pasien yang menginginkan fertilitas, yakni konisasi, trakelektomi sederhana, trakelektomi radikal. hingga pemberian kemoterapi neo-adjuvant. Pilihan terapi ini telah terbukti efektif dan aman, serta mampu mem pertahankan fungsi reproduksi pasien.

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Early stage cervical cancer: role of magnetic resonance imaging after conization in determining residual tumor

Abstract: Identifiable tumor on MRI after conization in patients with early stage cervical cancer was an independent predictor of residual tumor at final pathology.

Cited by 11 publications

References 33 publications

Cervical Cancer, Version 3.2019, NCCN Clinical Practice Guidelines in Oncology

Cervical Cancer, Version 3.2019, NCCN Clinical Practice Guidelines in Oncology

Prospective validation of craniocaudal tumour size on MR imaging compared to histoPAthology in patients with uterine cervical cancer: The MPAC study

Fertility-Sparing Surgery In Early Stage Cervical Cancer

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