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Preoperative magnetic resonance imaging criteria for predicting lymph node metastasis in patients with stage IB1‐IIA2 cervical cancer
OBJECTIVE: This study aimed to identify patients with stage IB1‐IIA2 cervical cancer at low risk for lymph node metastasis (LNM) using preoperative magnetic resonance imaging (MRI) parameters. METHODS: Clinical and MRI data of patients with stage IB1‐IIA2 cervical cancer who underwent radical surger...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8366085/ https://www.ncbi.nlm.nih.gov/pubmed/34278729 http://dx.doi.org/10.1002/cam4.4075 |
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author | He, Fangjie Zu, Shuiling Chen, Xia Liu, Jianping Yi, Ying Yang, Haijun Wang, Fuqiang Yuan, Songhua |
author_facet | He, Fangjie Zu, Shuiling Chen, Xia Liu, Jianping Yi, Ying Yang, Haijun Wang, Fuqiang Yuan, Songhua |
author_sort | He, Fangjie |
collection | PubMed |
description | OBJECTIVE: This study aimed to identify patients with stage IB1‐IIA2 cervical cancer at low risk for lymph node metastasis (LNM) using preoperative magnetic resonance imaging (MRI) parameters. METHODS: Clinical and MRI data of patients with stage IB1‐IIA2 cervical cancer who underwent radical surgery between 2010 and 2015 were retrospectively reviewed. Clinical stage IB1‐IIA2 cervical cancer was diagnosed according to the 2009 International Federation of Gynecology and Obstetrics staging system. The low‐risk criteria for LNM were identified using logistic regression analysis. The performance of the logistic regression analysis was estimated through receiver operating characteristic curve analysis. RESULTS: Of 453 patients, 105 (23.2%) exhibited pathological LNM (p‐LNM). The maximal tumor diameter (adjusted odds ratio [aOR], 1.586; 95% confidence interval [CI], 1.312–1.916; p < 0.001) and LNM (aOR, 2.384; 95% CI, 1.418–4.007; p = 0.001) on preoperative MRI (m‐LNM) were identified as independent risk factors for p‐LNM using a multivariate logistic analysis. The p‐LNM rate was 4.0% for low‐risk patients (n = 124) identified using the current criteria (maximal tumor diameter <3.0 cm and no sign of m‐LNM). The 5‐year disease‐free survival rate of low‐risk patients was significantly greater than the rate of patients with a maximal tumor diameter ˃3.0 cm and/or signs of m‐LNM (90.4% vs. 82.1%; p = 0.033). CONCLUSIONS: The low‐risk criteria for p‐LNM were a maximal tumor diameter <3.0 cm and no sign of m‐LNM. Patients with stage IB1‐IIA2 cervical cancer at low risk for m‐LNM could be candidates for radical surgery; hence, they have a lesser need for adjuvant chemoradiotherapy, thus avoiding the severe comorbidities it causes. |
format | Online Article Text |
id | pubmed-8366085 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-83660852021-08-23 Preoperative magnetic resonance imaging criteria for predicting lymph node metastasis in patients with stage IB1‐IIA2 cervical cancer He, Fangjie Zu, Shuiling Chen, Xia Liu, Jianping Yi, Ying Yang, Haijun Wang, Fuqiang Yuan, Songhua Cancer Med Clinical Cancer Research OBJECTIVE: This study aimed to identify patients with stage IB1‐IIA2 cervical cancer at low risk for lymph node metastasis (LNM) using preoperative magnetic resonance imaging (MRI) parameters. METHODS: Clinical and MRI data of patients with stage IB1‐IIA2 cervical cancer who underwent radical surgery between 2010 and 2015 were retrospectively reviewed. Clinical stage IB1‐IIA2 cervical cancer was diagnosed according to the 2009 International Federation of Gynecology and Obstetrics staging system. The low‐risk criteria for LNM were identified using logistic regression analysis. The performance of the logistic regression analysis was estimated through receiver operating characteristic curve analysis. RESULTS: Of 453 patients, 105 (23.2%) exhibited pathological LNM (p‐LNM). The maximal tumor diameter (adjusted odds ratio [aOR], 1.586; 95% confidence interval [CI], 1.312–1.916; p < 0.001) and LNM (aOR, 2.384; 95% CI, 1.418–4.007; p = 0.001) on preoperative MRI (m‐LNM) were identified as independent risk factors for p‐LNM using a multivariate logistic analysis. The p‐LNM rate was 4.0% for low‐risk patients (n = 124) identified using the current criteria (maximal tumor diameter <3.0 cm and no sign of m‐LNM). The 5‐year disease‐free survival rate of low‐risk patients was significantly greater than the rate of patients with a maximal tumor diameter ˃3.0 cm and/or signs of m‐LNM (90.4% vs. 82.1%; p = 0.033). CONCLUSIONS: The low‐risk criteria for p‐LNM were a maximal tumor diameter <3.0 cm and no sign of m‐LNM. Patients with stage IB1‐IIA2 cervical cancer at low risk for m‐LNM could be candidates for radical surgery; hence, they have a lesser need for adjuvant chemoradiotherapy, thus avoiding the severe comorbidities it causes. John Wiley and Sons Inc. 2021-07-18 /pmc/articles/PMC8366085/ /pubmed/34278729 http://dx.doi.org/10.1002/cam4.4075 Text en © 2021 The Authors. Cancer Medicine published by John Wiley & Sons Ltd. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Clinical Cancer Research He, Fangjie Zu, Shuiling Chen, Xia Liu, Jianping Yi, Ying Yang, Haijun Wang, Fuqiang Yuan, Songhua Preoperative magnetic resonance imaging criteria for predicting lymph node metastasis in patients with stage IB1‐IIA2 cervical cancer |
title | Preoperative magnetic resonance imaging criteria for predicting lymph node metastasis in patients with stage IB1‐IIA2 cervical cancer |
title_full | Preoperative magnetic resonance imaging criteria for predicting lymph node metastasis in patients with stage IB1‐IIA2 cervical cancer |
title_fullStr | Preoperative magnetic resonance imaging criteria for predicting lymph node metastasis in patients with stage IB1‐IIA2 cervical cancer |
title_full_unstemmed | Preoperative magnetic resonance imaging criteria for predicting lymph node metastasis in patients with stage IB1‐IIA2 cervical cancer |
title_short | Preoperative magnetic resonance imaging criteria for predicting lymph node metastasis in patients with stage IB1‐IIA2 cervical cancer |
title_sort | preoperative magnetic resonance imaging criteria for predicting lymph node metastasis in patients with stage ib1‐iia2 cervical cancer |
topic | Clinical Cancer Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8366085/ https://www.ncbi.nlm.nih.gov/pubmed/34278729 http://dx.doi.org/10.1002/cam4.4075 |
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