Tumor Size at Magnetic Resonance Imaging Association With Lymph Node Metastasis and Lymphovascular Space Invasion in Resectable Cervical Cancer: A Multicenter Evaluation of Surgical Specimens

Abstract

ObjectiveTo determine whether gross tumor volume (GTV) and the maximum diameter of resectable cervical cancer at magnetic resonance imaging (MRI) could predict lymph node metastasis (LNM) and lymphovascular space invasion (LVSI).Materials and MethodsA total of 315 consecutive patients with cervical cancer were retrospectively identified. Gross tumor volume and the maximum diameter of tumor were evaluated on MRI. Univariate and multivariate logistic regression analyses were performed to determine whether tumor size could predict LNM and LVSI. Cutoffs of GTV, maximum diameter, and the International Federation of Gynecology and Obstetrics (FIGO) classification of tumor were first investigated in 255 patients (group A) and then validated in an independent cohort of 60 patients (group B) using area under the receiver operating characteristic curve (AUC) analysis for predicting the presence of LNM and LVSI.ResultsUnivariate analysis showed that GTV and the maximum diameter of tumor could predict LNM and LVSI (all P < 0.0001). Multivariate analyses indicated GTV as an independent risk factor of LNM and LVSI (all P < 0.0001). In group A, GTV, the maximum diameter, and the FIGO stage could identify LNM (AUC, 0.813, 0.741, and 0.69, respectively) and LVSI (AUC, 0.806, 0.751, and 0.684, respectively). In group B, GTV, the maximum diameter, and the FIGO stage could help identify LNM (AUC, 0.902, 0.825, and 0.759, respectively) and LVSI (AUC, 0.771, 0.748, and 0.700, respectively).ConclusionsGross tumor volume and the maximum diameter of resectable cervical cancer at MRI demonstrated capability in predicting LNM and LVSI, which were more accurate than FIGO stage.

A new marker based on risk stratification of human papillomavirus DNA and tumor size to predict survival of locally advanced cervical cancer

“…Research has confirmed that tumor size can predict lymph node metastasis and lymph vascular space invasion in early-stage cervical cancer 30. Conversely, as T stage in TNM staging system can reflect tumor load in other solid tumors, the tumor size has been confirmed to be an independent prognostic factor for overall survival and distant metastasis-free survival in this study.…”

Prediction of lymphovascular space invasion using a combination of tenascin-C, Cox-2, and PET/CT radiomics in patients with early-stage cervical squamous cell carcinoma

“…Yang et al [31] determined found that the minimum apparent diffusion coe cient and the minimum apparent diffusion coe cient ratio were signi cantly lower in LVI-positive invasive cervical cancer than in LVI-negative invasive cervical cancer (0.772 ± 0.062 vs. 0.917 ± 0.052, p < 0.001, and 0.712 ± 0.078 × 10 −3 vs. 0.867 ± 0.099 × 10 −3 mm 2 /s, p < 0.001, respectively). Gross tumor volume [32] on MRI was also identi ed to be a possible independent risk factor for predicting LVSI (AUC = 0.700, p < 0.05). Recently, the use of radiomics based on magnetic resonance for predicting LVSI has been studied.…”

Correlation between hematological parameters and outcome in patients with locally advanced cervical cancer treated by concomitant chemoradiotherapy

“…However, most retrospective studies concerned patients treated by RT alone, and data on tumor size were not included, thus inducing significant bias. 8,9,33 Nevertheless, the associations between anemia and local recurrence and/or OS but also between hypoxia and radioresistance in animal models have led to the dogma that anemia increases tumor hypoxia in humans. 34 Concerning cervical cancer, a positive impact of anemia correction by RBC transfusions was described by Bush 12 in only one trial published in 1986.…”