Role of MR Imaging in the Selection of Patients with Early Cervical Carcinoma for Fertility-preserving Surgery: Initial Experience

Peppercorn, P D; Jeyarajah, Arjun; Woolas, Robert; Shepherd, John H.; Oram, David; Jacobs, Ian; Armstrong, Peter; Lowe, David; Reznek, Rodney H.

doi:10.1148/radiology.212.2.r99au01395

Cited by 120 publications

(48 citation statements)

References 9 publications

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“…MRI was used as it is the most effective modality at determining parametrial disease 18 and also help identify endocervical involvement and suitability for trachelectomy. 18 Isthmic surveillance using cytology can produce confusing results, 19,20 which is why a colposcopic assessment was also used for follow up. The reliability of cytology is greater if assessed by an experienced cytopathologist.…”

Section: Discussionmentioning

confidence: 99%

Radical vaginal trachelectomy as a fertility‐sparing procedure in women with early‐stage cervical cancer—cumulative pregnancy rate in a series of 123 women

Shepherd

Spencer

Herod

et al. 2006

BJOG

200

126

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Objective To analyse the fertility rates, complications and recurrences in a group of women who have undergone radical vaginal trachelectomy and pelvic lymphadenectomy for early-stage cervical cancer.Design An observational series.Setting A Gynaecological Oncology Centre.Population One hundred and twenty-three consecutive women who underwent radical vaginal trachelectomy and pelvic lymphadenectomy for early-stage cervical cancer.Methods Data were collected prospectively.Main outcome measures Complications, recurrences, pregnancies and live births are presented as percentages of the total population. Fertility is presented as a 5-year cumulative rate, with women attempting to conceive as the denominator.Results A total of 123 women were followed up for an average of 45 months. Eleven (8.9%) had completion treatment (two radical hysterectomies and nine chemoradiotherapy) at the time of initial treatment. There were three recurrences (2.7%) among the women who did not have completion treatment and two (18.2%) in those who did. There were 6 perioperative and 26 postoperative complications. Sixty-three women attempted pregnancy. There were 55 pregnancies in 26 women and 28 live births in 19. Three women had continuing pregnancies. The 5-year cumulative pregnancy rate among women trying to conceive was 52.8%. All but two women were delivered by classical caesarean section and seven (25.0%) babies were born at 31 + 6 weeks or less.Conclusions For selected women with early-stage cervical cancer, radical vaginal trachelectomy and pelvic lymphadenectomy are fertility-sparing options, with a low incidence of recurrence and acceptable cumulative conception rates. Complications are few, although there is a high premature labour and miscarriage rate among pregnant women.

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Section: Discussionmentioning

confidence: 99%

Radical vaginal trachelectomy as a fertility‐sparing procedure in women with early‐stage cervical cancer—cumulative pregnancy rate in a series of 123 women

Shepherd

Spencer

Herod

et al. 2006

BJOG

200

126

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“…The ICO is not accessible to clinical examination and hysteroscopy is costly and invasive. MRI is safe with high sensitivity (86%91%) and specificity (94%96%) values for evaluating tumor extension to the corpus uteri [32,36] (Figure 3).…”

Section: Internal Os Involvementmentioning

confidence: 99%

Current imaging strategies for the evaluation of uterine cervical cancer

Bourgioti

Chatoupis

Moulopoulos

2016

WJR

105

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Uterine cervical cancer still remains an important socioeconomic issue because it largely affects women of reproductive age. Prognosis is highly depended on extent of the disease at diagnosis and, therefore, accurate staging is crucial for optimal management. Cervical cancer is clinically staged, according to International Federation of Gynecology and Obstetrics guidelines, but, currently, there is increased use of cross sectional imaging modalities [computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography-CT (PET-CT)] for the study of important prognostic factors like tumor size, parametrial invasion, endocervical extension, pelvic side wall or adjacent/distal organs involvement and lymph node status. Imaging indications also include cervical cancer follow-up, evaluation of tumor response to treatment and selection of suitable candidates for less radical surgeries like radical trachelectomy for fertility preservation. The preferred imaging method for local cervical cancer evaluation is MRI; CT is equally effective for evaluation of extrauterine spread of the disease. PET-CT shows high diagnostic performance for the detection of tumor relapse and metastatic lymph nodes. The aim of this review is to familiarize radiologists with the MRI appearance of cervical carcinoma and to discuss the indications of cross sectional imaging during the course of the disease in patients with cervical carcinoma.

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“…One such surgery is radical trachelectomy, which involves removal of the cervix but preservation of the uterine body [3,4]. The degree of tumour extension toward the internal os must be determined before planning a radical trachelectomy [5]. Preoperative evaluation of tumour size and degree of stromal invasion is also important in planning treatment.…”

mentioning

confidence: 99%

Comparison of T2-weighted and contrast-enhanced T1-weighted MR imaging at 1.5 T for assessing the local extent of cervical carcinoma

et al. 2011

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Role of MR Imaging in the Selection of Patients with Early Cervical Carcinoma for Fertility-preserving Surgery: Initial Experience

Abstract: This is a small study, but MR imaging appears accurate in the prediction of myometrial tumor involvement and in showing the relationship of cervical carcinoma to the internal os and, hence, the patient's suitability for trachelectomy.

Cited by 120 publications

References 9 publications

Radical vaginal trachelectomy as a fertility‐sparing procedure in women with early‐stage cervical cancer—cumulative pregnancy rate in a series of 123 women

Radical vaginal trachelectomy as a fertility‐sparing procedure in women with early‐stage cervical cancer—cumulative pregnancy rate in a series of 123 women

Current imaging strategies for the evaluation of uterine cervical cancer

Comparison of T2-weighted and contrast-enhanced T1-weighted MR imaging at 1.5 T for assessing the local extent of cervical carcinoma

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