Tumoral volume measured preoperatively by magnetic resonance imaging is related to survival in endometrial cancer

Coronado, Pluvio; Santiago-López, Javier de; Santiago-García, Javier de; Méndez, Ramiro; Fasero, María; Herráiz, M.

doi:10.2478/raon-2020-0064

Cited by 4 publications

(8 citation statements)

References 22 publications

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“…In our opinion, it should be considered to implement the long-standing suggestions regarding the use of tumor dimensions in future updates of the FIGO EC guidelines. Based on our study results and in accordance with the above-mentioned evidence in the literature [ 20 , 21 , 22 , 23 , 24 ], it could be recommended to include a tumor diameter larger than 40 mm or tumor volume larger than 20 mL as additional criteria in the selection of patients for pelvic lymph node dissection. Tumor size may be measured via TVU or MRI, but MRI may have added value in the case of small tumors with doubtful findings on TVU or for more accurately measuring tumor size and detection of imaging signs of ≥pT1b disease.…”

Section: Discussionsupporting

confidence: 80%

“…They are associated with a poorer prognosis, and therefore lymphadenectomy is recommended in addition to hysterectomy in these cases [ 2 , 7 , 10 , 12 , 13 , 14 , 15 , 16 , 21 , 25 ]. Pelvic and para-aortic lymph node resection holds a risk of lymphocele and/or lower limb oedema [ 23 ]. The sentinel lymph node (SLN) has now become the new standard procedure as it may eliminate the need for extensive lymphadenectomy without risks of suboptimal treatment.…”

Section: Discussionmentioning

confidence: 99%

“…Tumor size is a relatively easy and reproducible parameter to measure, and it is easier than determining the 50% threshold of myometrial invasion via MRI as well as via histopathology. A single size diameter cannot always accurately describe the exact size of a tumor; therefore, like other researchers [ 23 , 24 ], we estimated tumor volume in our study by applying the ellipsoid formula based on three perpendicular maximum diameters. There are currently many technological advancements available to allow for more fast, easy and accurate automatic calculations of tumor volumes in 3D.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, EC tumor size can be measured relatively easily via preoperative MRI and may be a useful biomarker in the management of EC. EC tumor size has been suggested to be an independent prognostic factor and may even predict distant failure more accurately as compared to the depth of myometrial invasion [ 20 , 21 , 22 , 23 , 24 ].…”

Section: Introductionmentioning

confidence: 99%

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Performance of MRI for Detection of ≥pT1b Disease in Local Staging of Endometrial Cancer

Van Vynckt,

Tummers,

Denys

et al. 2024

Cancers

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Magnetic resonance imaging (MRI) can be used for the preoperative local staging of endometrial cancer (EC). The presence of ≥pT1b disease (i.e., tumor invasion in ≥50% of the myometrium, into the cervical stroma or spread outside the uterus) has important prognostic value and implications for the decision to perform lymphadenectomy. The purpose of this study was to assess the performance of MRI for the detection of ≥pT1b disease and to evaluate whether tumor size measured via MRI was predictive for ≥pT1b disease, independent of imaging signs of deep invasion. MRI T-staging and tumor diameter and volume were correlated with histopathology of the hysterectomy specimen in 126 patients. MRI had a sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 70.0%, 83.3%, 79.2%, 75.3% and 77.0%, respectively, for the detection of ≥pT1b disease. A tumor diameter of ≥40 mm and volume of ≥20 mL measured via MRI were predictive for ≥pT1b disease at rates of 78.3% and 87.1%, respectively. An EC size of at least 5 mm upon MRI was predictive for ≥pT1b disease in more than 50% of cases. Our results support the use of MRI in the preoperative staging of EC and suggest including size criteria in EC staging guidelines.

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Section: Discussionsupporting

confidence: 80%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Performance of MRI for Detection of ≥pT1b Disease in Local Staging of Endometrial Cancer

Van Vynckt,

Tummers,

Denys

et al. 2024

Cancers

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“…In a recent study published by Coronado et al 24 using the same formula, established 10 cm 3 or greater to classify the high‐risk group associated with poor prognosis in relation with survival and recurrence. Coronado et al 24 analyzed the tumor volume on preoperative MRI in a Spanish population similar to the population of the present study. Using a formula based on diameters, they showed that tumor volume is an independent prognostic factor.…”

Section: Discussionmentioning

confidence: 99%

Role of tumor volume in endometrial cancer: An imaging analysis and prognosis significance

López‐González,

Rodriguez‐Jiménez,

Gómez‐Salgado

et al. 2023

Intl J Gynecology & Obste

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ObjectiveTo evaluate the prognostic value of tumor volume on preoperative MRI in endometrial cancer (EC) patients and its association with adverse prognostic factors and survival.MethodsA retrospective observational study with 127 consecutive patients with endometrioid EC was carried out between 2016 and 2021 at Juan Ramón Jiménez University Hospital, Huelva (Spain). All patients underwent preoperative magnetic resonance imaging (MRI) for local staging. The tumor volume was analyzed on MRI by two different methods: by measuring the three maximum diameters of the tumor according to an ellipse formula and by manual region of interest in different sections; the ratio between tumor volume and uterus volume was also calculated as a third tool. The relationships between volume, prognostic factors, and survival were analyzed.ResultsA total of 127 patients with endometroid EC underwent preoperative MRI and were included in the study. Tumor volume was significantly higher for deep myometrial invasion, cervical stromal involvement, infiltrated serosa, lymph node metastases, high‐grade EC, and lymphovascular space involvement, advanced FIGO stage, and High Recurrence Risk Group (P < 0.001). ROC curves showed that tumor volume greater than 25 cm3 predicts lymph node metastases. Volume index greater than 17 cm3 was associated with reduced disease‐free survival (P < 0.001) and overall survival (P < 0.003). Multivariate analysis showed that the greatest tumor volume had an independent impact on recurrence (odds ratio [OR]1.019, 95% confidence interval [CI] 1.005–1.032) and survival (OR 1.027, 95% CI 1.009–1.046).ConclusionsThis study shows an important correlation between tumor volume on MRI and poor prognostic factors. Preoperative tumor volume on MRI is a valuable biomarker to be considered for management of EC.

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Exploring the significance of tumor volume in endometrial cancer: Clinical pathological features, prognosis, and adjuvant therapies

Fan,

Sun,

Han

et al. 2023

Medicine

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To assist clinicians in formulating treatment strategies for endometrial cancer (EC), this retrospective study explores the relationship between tumor volume and clinical pathological features, as well as prognosis, in patients undergoing staging surgery. Preoperative pelvic MRI examinations were conducted on 234 histologically confirmed EC patients. The ITK-SNAP software was employed to manually delineate the region of interest in the MRI images and calculate the tumor volume (MRI-TV). The analysis focused on investigating the relationship between MRI-TV and the clinical pathological features and prognosis of EC patients. Larger MRI-TV was found to be associated with various adverse prognostic factors (G3, deep myometrial invasion, cervical stromal invasion, lymphovascular space invasion, lymph node metastasis, advanced international federation of gynecology and obstetrics staging, and receipt of adjuvant therapy). The receiver operating characteristic curve indicated that MRI-TV ≥ 8 cm3 predicted deep myometrial invasion, and MRI-TV ≥ 12 cm3 predicted lymph node metastasis. Penalized spline (P-spline) regression analysis identified 14 cm3 of MRI-TV as the optimal prognostic cutoff value. MRI-TV ≥ 14 cm3 was an independent prognostic factor for overall survival and disease-free survival. For patients with MRI-TV ≥ 14 cm3, the disease-free survival rate with adjuvant therapy was superior to that of the sole staging surgery group. This study demonstrates a significant correlation between MRI-TV and clinical pathological features and prognosis in EC. For patients with MRI-TV ≥ 14 cm3, staging surgery followed by adjuvant therapy was superior to sole staging surgery.

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Tumoral volume measured preoperatively by magnetic resonance imaging is related to survival in endometrial cancer

Cited by 4 publications

References 22 publications

Performance of MRI for Detection of ≥pT1b Disease in Local Staging of Endometrial Cancer

Performance of MRI for Detection of ≥pT1b Disease in Local Staging of Endometrial Cancer

Role of tumor volume in endometrial cancer: An imaging analysis and prognosis significance

Exploring the significance of tumor volume in endometrial cancer: Clinical pathological features, prognosis, and adjuvant therapies

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