Effects of Treatment of Uterine Cervical Carcinoma Monitored by Magnetic Resonance Imaging - Sarajevo Experience

GOAL: The goal of this study was the determination of the effects in treatment of early stage (<IIB) and locally advanced stages (≥IIB) of uterine cervical carcinoma by using MRI. MATERIAL AND METHODS: The study was a prospective, comparative, analytical, and observational and included 74 patients with cervical cancer (PH confirmed). All 74 patients have initially gone through the pre-therapeutic MRI to determine the tumour FIGO stage. At a renewal of the initial MRI findings, patients were divided into two study groups: group A and group B. Group A consisted from 39 patients with early-stage cervical carcinoma (<IIB) and group B comprised from 35 patients with locally advanced stage (≥IIB). Postterapeutic MRI control, were perfomed in both group (A and B). Further MRI examinations were set for the patients from both groups. RESULTS: An analysis of treatment outcomes in group A showed that most patients had no local recurrence or residuum disease in 89.7%, while local recurrence was observed in only 10.3% cases. An analysis of treatment outcomes in group B showed that most patients had complete regression after local chemoradiotherapy in 68.8%, while 25.7% of patients had local progression of the disease, while the 5.7% cases recorded partial local tumour regression(p<0.05). It has been shown that a complete local regression was more frequent in the case of squamous cell carcinoma in 74.2% vs 25% in adenocarcinoma cases. Also local and partial regression was observed more frequently in the case of squamous cell carcinoma in 6.5% compared to 0% in adenocarcinoma, while progression was more common in adenocarcinoma at 75% compared to 19.4% for squamous cell (p<0.05). MRI results showed positive outcome of treatment group A and B in our study, showed a statistically significant difference in favour of group A (89.7%) compared to group B 68.8% (p<0.05). CONCLUSION: The results obtained from our studies show that early stage cervical cancer (<IIB) shows a better outcome in treatment of advanced stages (≥IIB). In the treatment of advanced stages (≥IIB), concomitant radio chemotherapy shows significant results in terms of complete tumour regression, especially in squamous cell type of cervical cancer.