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#451 Magnetic resonance imaging or expert ultrasound in preoperative local staging of patients with early-stage cervical cancer: final results of the SENTIX prospective, single-arm, international trial (CEEGOG CX-01; ENGOT-CX2)
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  1. Roman Kocián1,
  2. Kathrin Siegler2,
  3. Jaroslav Klát3,
  4. Klára Benešová4,
  5. Mariachiara Paderno5,
  6. Luc Van Lonkhuijzen6,
  7. Barbora Chaloupková7,
  8. Radovan Pilka8,
  9. Martin Michal9,
  10. Peter Kašcák10,
  11. Frédéric Kridelka11,
  12. Maja Pakiž12,
  13. Leon Cornelius Snyman13,
  14. Marc Barahona14,
  15. Sambor Sawicki15,
  16. Pawel Blecharz16,
  17. Mikuláš Redecha17,
  18. Róbert Tóth18,
  19. David Cibula1 and
  20. Christhardt Köhler2
  1. 1First Faculty of Medicine, Charles University and General University Hospital in Prague, Department of Obstetrics and Gynecology, CEEGOG, Prague, Czech Republic
  2. 2Asklepios-Clinic Hamburg Altona, Department of Gynaecology, Hamburg, Germany
  3. 3University Hospital Ostrava, Department of Obstetrics and Gynecology, CEEGOG, Ostrava, Czech Republic
  4. 4Faculty of Medicine, Masaryk University, Institute of Biostatistics and Analyses, Brno, Czech Republic
  5. 5San Gerardo Hospital, Department of Obstetrics and Gynecology, Unit of Gynecologic Oncology Surgery, Monza, Italy
  6. 6Amsterdam University Medical Centers, Center for Gynecologic Oncology, Cancer Center Amsterdam, Amsterdam, The Netherlands
  7. 7Krajská nemocnice T. Bati, a. s., CEEGOG, Zlín, Czech Republic
  8. 8Faculty of Medicine and Dentistry, Palacky University, University Hospital Olomouc, Department of Obstetrics and Gynecology, CEEGOG, Olomouc, Czech Republic
  9. 9Hospital Ceske Budejovice, JSC, Department of Obstetrics and Gynaecology, CEEGOG, Ceské Budejovice, Czech Republic
  10. 10University Hospital Trencin, Department of Obstetrics and Gynecology, CEEGOG, Trencín, Slovakia
  11. 11CHU de Liege, BGOG, Liege, Belgium
  12. 12University Medical Centre Maribor, University Clinic for Gynaecology and Perinatology, CEEGOG, Maribor, Slovenia
  13. 13University of Pretoria, Kalafong Provincial Tertiary Hospital, Department of Obstetrics and Gynaecology, Pretoria, South Africa
  14. 14University of Barcelona, Biomedical Research Institute of Bellvitge, Bellvitge University Hospital, Department of Gynecology, Barcelona, Spain
  15. 15Medical University of Gdansk, Department of Perinatology, Gynecology, Gynecological Oncology and Gynecologic Endocrinology, CEEGOG, Gdansk, Poland
  16. 16Maria Sklodowska-Curie National Research Institute of Oncology, Cracow Branch, CEEGOG, Cracow, Poland
  17. 17Bory Hospital, Department of obstetrics and gynecology, CEEGOG, Bratislava, Slovakia
  18. 18Oncology Institute of East Slovakia, CEEGOG, Košice, Slovakia

Abstract

Introduction/Background SENTIX is a prospective, single-arm, international study of sentinel lymph node (SLN) biopsy without pelvic lymph node dissection (PLND) in patients with early-stage cervical cancer. We report the sensitivity of magnetic resonance imaging (MRI) and expert ultrasound (EUS) in preoperative clinical staging.

Methodology Forty-seven sites from 18 countries participated in the study. Patients with stages 1A1/LVSI+ to 1B2 (FIGO 2018), usual histological types, and no suspicious lymph nodes on imaging were prospectively enrolled between May 2016 and October 2020. One imaging method, either pelvic MRI or EUS, was mandatory for preoperative local staging and was chosen at the investigator’s discretion.

Results Among 690 prospectively enrolled patients fulfilling the inclusion criteria, MRI and EUS were performed as the staging imaging modality in 46.7% and 43.1% of patients, respectively, and 10.1% underwent both. Preoperatively unrecognized parametrial involvement was detected by pathology in 26 patients (3.8%) and SLN metastatic involvement in 68 (9.9%) patients, of which 54.4% and 45.6% had micrometastasis and macrometastasis, respectively, as the largest type of metastasis. MRI and EUS showed comparable sensitivity for tumour size measurement and for the failure to detect parametrial, or macrometastatic LN involvement (table 1). Combining both imaging methods did not increase the outcome (table 1).

Conclusion Pelvic MRI and EUS are equally sensitive methods for assessing clinically relevant parameters in preoperative clinical staging of cervical cancer, including tumour size, parametrial involvement, and macrometastatic nodal involvement.

Disclosures The authors declare no conflict of interest.

Trial registration ClinicalTrials.gov: NCT02494063

Abstract #451 Table 1

Sensitivity of pelvic MRI and EUS in preoperative staging of patients with cervical cancer

Funding This work was supported by Charles University in Prague (UNCE 204065 and PROGRES Q28/LF1) and by a grant from the Czech Health Research Council (NV19–03-00023). The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the presentation; or in the decision to publish the results.

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