Stage IB1 Cervical Cancer: Role of Preoperative MR Imaging in Selection of Patients for Fertility-Sparing Radical Trachelectomy

Lakhman, Yulia; Akın, Oğuz; Park, Kay J.; Sarasohn, Debra; Zheng, Junting; Goldman, Debra A.; Sohn, Michael; Moskowitz, Chaya S.; Sonoda, Yukio; Hricak, Hedvig; Abu‐Rustum, Nadeem R.

doi:10.1148/radiol.13121746

Cited by 81 publications

(68 citation statements)

References 41 publications

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“…Therefore, MRI may be an alternative tool for assessing DSI in early-stage cervical cancer. However, the performance of MRI is limited primarily by the difficulty of distinguishing a tumor from post-procedural inflammation, and by the fact that accuracy for detection of DSI might be improved if the MRI were performed before conization [25]. …”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Parametrial Involvement in Early-Stage Cervical Cancer and Identification of Patients Suitable for Less Radical Surgery

Jiamset

Hanprasertpong²

2016

Oncol Res Treat

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Background: The aim of this study was to determine risk factors associated with parametrial involvement (PI) and to identify the subgroup of patients at low risk for PI. Methods: The study comprised 565 patients with early-stage cervical cancer, who underwent radical hysterectomy with pelvic node dissection at Songklanagarind Hospital between 1987 and 2011. Analysis was performed to determine factors associated with PI. Results: Overall, 24 (4.25%) women had PI. PI was more common in patients with non-squamous cell carcinoma, deep stromal invasion (DSI), tumor size > 2 cm, lymphovascular space invasion (LVSI), and pelvic node involvement. Multivariate analysis showed that DSI (p < 0.001) and tumor size > 2 cm (p < 0.001) were independently associated with PI. PI was linked with decreased recurrence-free (p < 0.001) and overall (p = 0.002) survival. Of 347 patients with tumor size ≤ 2 cm and no DSI, only 1 (0.29%) had PI. Conclusion: These findings confirm that PI in early-stage cervical cancer is uncommon. Risk factors associated with PI were DSI and tumor size > 2 cm. PI is a predictor of cervical cancer recurrence and decreased survival. Less radical surgery may be considered in low-risk patients.

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Section: Discussionmentioning

confidence: 99%

Risk Factors for Parametrial Involvement in Early-Stage Cervical Cancer and Identification of Patients Suitable for Less Radical Surgery

Jiamset

Hanprasertpong²

2016

Oncol Res Treat

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“…Preoperative MRI provides useful information on tumor size, parametrial status and lymph nodes, contributing to the more accurate selection of candidates for trachelectomy. Recently, it has been shown that patients with a ≤ 5 mm distance between tumor and ICO on MRI, fare better with radical hysterectomy than trachelectomy [56] . MRI may also be used for monitoring patients after trachelectomy.…”

Section: Trachelectomy Patientsmentioning

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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“…Eligibility requirements include tumor smaller than 2 cm, distance from tumor margin to internal cervical os of more than 1 cm, and absence of lymph node metastases. MR imaging assesses the extent of local tumor with high accuracy (13) and is routinely used for patient selection. 18 F-FDG PET/CT is also used in many institutions to evaluate for lymphadenopathy.…”

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confidence: 99%

Evaluation of Gynecologic Cancer with MR Imaging, ¹⁸F-FDG PET/CT, and PET/MR Imaging

2015

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Stage IB1 Cervical Cancer: Role of Preoperative MR Imaging in Selection of Patients for Fertility-Sparing Radical Trachelectomy

Abstract: Pretrachelectomy MR imaging can help identify high-risk patients likely to need radical hysterectomy or confirm the absence of residual tumor in the cervix after a cone biopsy with negative margins.

Cited by 81 publications

References 41 publications

Risk Factors for Parametrial Involvement in Early-Stage Cervical Cancer and Identification of Patients Suitable for Less Radical Surgery

Risk Factors for Parametrial Involvement in Early-Stage Cervical Cancer and Identification of Patients Suitable for Less Radical Surgery

Current imaging strategies for the evaluation of uterine cervical cancer

Evaluation of Gynecologic Cancer with MR Imaging, ¹⁸F-FDG PET/CT, and PET/MR Imaging

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Stage IB1 Cervical Cancer: Role of Preoperative MR Imaging in Selection of Patients for Fertility-Sparing Radical Trachelectomy

Abstract: Pretrachelectomy MR imaging can help identify high-risk patients likely to need radical hysterectomy or confirm the absence of residual tumor in the cervix after a cone biopsy with negative margins.

Cited by 81 publications

References 41 publications

Risk Factors for Parametrial Involvement in Early-Stage Cervical Cancer and Identification of Patients Suitable for Less Radical Surgery

Risk Factors for Parametrial Involvement in Early-Stage Cervical Cancer and Identification of Patients Suitable for Less Radical Surgery

Current imaging strategies for the evaluation of uterine cervical cancer

Evaluation of Gynecologic Cancer with MR Imaging, 18F-FDG PET/CT, and PET/MR Imaging

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Evaluation of Gynecologic Cancer with MR Imaging, ¹⁸F-FDG PET/CT, and PET/MR Imaging