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Parametrial Involvement on Magnetic Resonance Imaging Has No Effect on the Survival of Early-Stage Cervical Cancer Patients
  1. Kyungmi Yang, MD*,
  2. Won Park, MD, PhD*,
  3. Seung Jae Huh, MD, PhD*,
  4. Byung Kwan Park, MD, PhD,
  5. Chan Kyo Kim, MD, PhD,
  6. Byoung-Gie Kim, MD, PhD,
  7. Duk-Soo Bae, MD, PhD and
  8. Jeong-Won Lee, MD, PhD
  1. *Departments of Radiation Oncology,
  2. Departments of Radiology, and
  3. Departments of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Korea.
  1. Address correspondence and reprint requests to Won Park, MD, PhD, Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University, School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710, Seoul, Korea. E-mail: wonro.park@samsung.com.

Abstract

Objectives Parametrial involvement (PMI) in patients with cervical cancer is known to be an unfavourable prognostic factor. The purpose of this study was to investigate the prognostic significance of PMI on magnetic resonance imaging (MRI) in patients with early-stage cervical cancer.

Methods Three hundred three patients with stage IB or IIA cervical cancer treated by adjuvant radiotherapy or concurrent chemoradiotherapy following primary surgery from 2001 to 2011 were enrolled in this study. We reviewed preoperative MRI and pathologic findings and compared recurrence and survival of group defined according to PMI status.

Results There were 73 patients (24.1%) with PMI based on MRI and 52 patients (17.2%) with PMI based on surgical pathology. The accuracy of MRI for detecting PMI was 77.2% (sensitivity, 53.8%; specificity, 82.1%). In all patients, pathology-based evidence of PMI had a negative effect on both 5-year disease-free survival (73.2% vs 85.3%, P = 0.048) and 5-year overall survival (76.6% vs 91.4%, P = 0.009), but PMI on MRI did not have a significant effect on survival. In subgroups defined according to PMI status on MRI and surgical pathology, subgroups with pathology-based evidence of PMI showed a trend of a lower survival rate, regardless of PMI on MRI, but without statistical significance.

Conclusions Unlike pathologic results, PMI on MRI was not associated with recurrence or survival in patients with early-stage cervical cancer.

  • Adjuvant radiotherapy
  • Hysterectomy
  • Magnetic resonance imaging
  • Parametrial involvement
  • Uterine cervical cancer

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Footnotes

  • The authors declare no conflicts of interest.