title: Barrel index of bulky cervical tumours and intrauterine fluid determined by MRI as additional prognostic factors for survival.
abstract: OBJECTIVE
  to investigate whether morphologic characteristics determined by magnetic resonance imaging (MRI) can discriminate between bulky cervical tumours with a favourable or worse prognosis.
  
  
  METHODS
  MRI examinations were performed in 24 patients with cervical cancer Stage >or= 1B2. The ratio between tumour width and length (barrel index: BI) and the presence of intrauterine fluid retention were related to survival in a multivariate regression analysis.
  
  
  RESULTS
  BI and intracavital fluid were predictors of survival, independent from tumour diameter and other known important factors for survival. A cut-off value of 1.40 for the BI proved to be the best prognostic factor with respect to recurrence and death: the hazard ratios of BI > 1.40 as compared to BI <or= 1.40 were 18.9 (95% CI 2.8 to 125.6) for recurrent disease and 16.4 (95% CI 2.9 to 93.9) for death by cervical cancer. The hazard ratios of intracavital fluid retention were 73.6 (95% CI 5.3 to 1,016.4) and 48.1 (95% CI 4.7 to 491.6) for recurrence and death, respectively.
  
  
  CONCLUSIONS
  The morphologic characteristic BI and the presence or absence of intracavital fluid as determined by MRI might have predictive value for survival in patients with bulky cervical tumours.
authors: Department of Gynaecology, Leiden University Medical Center, Leiden, The Netherlands. s.a.h.m.van_den_tillaart@lumc.nl
authors: S A H M
authors: SA
authors: van den Tillaart
authors: A
authors: A
authors: Srámek
authors: M N J M
authors: MN
authors: Wasser
authors: J B M Z
authors: JB
authors: Trimbos
mesh_terms: D001826:Body Fluids; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D011379:Prognosis; D016016:Proportional Hazards Models; D002583:Uterine Cervical Neoplasms / Q000401:mortality* / Q000473:pathology*