EP29.05: Importance of an adequate study in patients with primary amenorrhea and pelvic tumour

Abstract

Objectives: Ultrasound has important role in diagnosing and evaluating treatment response to cervical carcinoma. Superb Microvascular Imaging (SMI) is a notable ultrasound technology that can remove motion artefact and visualise low blood flow. To investigate the efficacy of SMI in cervical carcinoma, we used SMI in patients with advanced cervical carcinoma through neoadjuvant chemotherapy. Methods: Between 2016 and 2017, we enrolled patients with cervical carcinoma. All patients received Paclitaxel, Cisplatin, Bevacizumab (TPB) as neoadjuvant chemotherapy and followed by radical hysterectomy. We measured serum SCC levels, tumour volume and blood flow with SMI. We also performed magnetic resonance imaging (MRI) and positron emission tomography (PET). We compared the pathological findings with clinical assessment including physical examination, serum SCC, MRI, PET and vascularisation of SMI. Results: Six patients were enrolled in this study. Three patients were stage 2B, 2 were 3B, and 1 was 4B of cervical carcinoma. The mean age was 62.0, mean maximal diameter of tumour was 5.2 cm, and histological types of all patients were squamous cell carcinoma. At diagnosis, there were 5 patients had high serum SCC and the other one was negative. SMI revealed vascularisation of blood flow clearly in all cases. Though serum SCC was stable in three patients after 1 course of TPB, decreased blood flow was detected by SMI in all cases. All patients could continue 3 courses of TPB. After neoadjuvant chemotherapy, MRI and PET showed complete response (CR) in 4 patients and partial response (PR) in 2 patients. SMI detected blood flow in 5 patients, which could not be detected by colour Doppler. Pathological examination showed 2 cases of pathological CR and 4 cases of pathological PR. SMI could detect the vascularisation of residual tumour in 4 patients. Conclusions:In patients with advanced cervical carcinoma, ultrasound with SMI was useful to monitor the treatment response of chemotherapy and reveal the blood flow of residual tumour. EP29.03Accuracy of 2D ultrasonography in detecting lymph node metastasis in uterine and cervical malignancies at the Philippine General Hospital: a five-year retrospective study Department of Obstetrics and Gynecology, University of the Philippines, Philippine General Hospital, Manila, PhilippinesObjectives: To determine the accuracy of 2D ultrasound in detecting lymph node metastasis in uterine and cervical malignancies. Methods: This is a five-year retrospective, cross-sectional study involving patients with uterine and cervical malignancies (stages IA2 to IIA2) who underwent bilateral pelvic lymph node dissection and para-aortic lymph node sampling. All had 2D ultrasound performed within two months prior to surgery. Ultrasound findings were compared with the gold standard which is the histopathologic result. Results: A total of 319 patients were included, 267 (84%) with uterine cancer and 53 (16%) with cervical cancer.Adenocarcinoma, endometrioid type was the most common histologic type among uter...