Objective The aim of the study was to investigate the value of mean apparent diffusion coefficient (ADC_mean) value in predicting the prognosis of stage IB-IIA cervical squamous cell carcinoma (SCC) patients after radical hysterectomy.

Materials and Methods A total of 126 patients who were with stage IB-IIA cervical SCC and underwent magnetic resonance imaging examination and radical hysterectomy were retrospectively investigated. Receiver operating characteristic curve was used to determine the cutoff values of ADC_mean for predicting earlier recurrence (2 consecutive increases in the SCC antigen value of more than 1 ng/mL or elevation of greater than 1.5 ng/mL). Disease-free survival and overall survival were analyzed using the Kaplan-Meier method, and differences between the survival curves were examined using the log-rank test.

Results Earlier recurrence was observed in 46 patients (36.2%) during a median follow-up of 22 months. The ADC_mean value (P = 0.005), parametrial invasion (P = 0.049), and lymphovascular space invasion (P = 0.037) were significantly associated with earlier recurrence. Receiver operating characteristic curve identified that the cutoff value of ADC_mean for predicting earlier recurrence was 0.785 × 10⁻³mm²/s. The ADC_mean value, parametrial invasion, and lymphovascular space invasion were significantly associated with earlier recurrence. The hazard ratios were 7.33 (95% confidence interval [95% CI], 1.854–28.99), 4.88 (95% CI, 1.00–23.73), and 2.53 (95% CI, 1.058–6.052), respectively. Disease-free survival and overall survival rates of patients with the ADC_mean less than 0.785 × 10⁻³mm²/s were significantly worse than those of patients with the ADC_mean greater than or equal to 0.785 × 10⁻³mm²/s.

Conclusions Mean ADC was a good biomarker in predicting the prognosis of stage IB-IIA cervical SCC after radical hysterectomy.