Preoperative MRI criteria for trials on less radical surgery in Stage IB1 cervical cancer.
OBJECTIVE
The aim of this study is to identify a patient group with a low-risk of parametrial involvement (PMI) in Stage IB1 cervical cancer using preoperative magnetic resonance imaging (MRI) parameters.


METHODS
In total, 190 Stage IB1 cervical cancer patients with clinically visible lesions who had undergone Type C2 radical hysterectomy and preoperative MRI were included in this study. Clinical records, pathology reports, and preoperative MRI findings were reviewed retrospectively.


RESULTS
Of the 190 patients, 19 (10%) had pathologic PMI. The largest tumor diameter identified by MRI ranged from zero (no definite mass on the cervix) to 60 mm, with a median of 21 mm. Patients were identified as being either low-risk (tumor size ≤25 mm and no evidence of PMI, n=127) or high-risk (tumor size >25 mm and/or findings indicating PMI, n=63) based on MRI parameters. The rate of pathologic PMI in low- and high-risk patients was 0.0% and 30.2%, respectively (P<0.001). Five-year progression-free survival in low-risk patients was 95.9%, which is significantly better than the rate of 85.6% for patients in the high-risk group (P=0.039).


CONCLUSIONS
Preoperative MRI parameters can help identify patients with a low-risk of PMI and, therefore, possible candidates for trials on less radical surgery.
Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Republic of Korea.
Jung-Yun
JY
Lee
Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Republic of Korea.
Jina
J
Youm
Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Republic of Korea.
Tae Hun
TH
Kim
Department of Radiology, Seoul National University College of Medicine, Seoul, Republic of Korea.
Jeong Yeon
JY
Cho
Department of Pathology, Seoul National University College of Medicine, Seoul, Republic of Korea.
Min A
MA
Kim
Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea.
Dong Hoon
DH
Suh
Center for Uterine Cancer, National Cancer Center, Goyang, Gyeonggi-do, Republic of Korea.
Myong Cheol
MC
Lim
Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Republic of Korea. Electronic address: kjwksh@snu.ac.kr.
Jae-Weon
JW
Kim
Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Republic of Korea.
Noh Hyun
NH
Park
Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Republic of Korea.
Yong-Sang
YS
Song
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008197:Lymph Node Excision; D008279:Magnetic Resonance Imaging / Q000379:methods; D008875:Middle Aged; D009367:Neoplasm Staging; D011300:Preoperative Care; D012189:Retrospective Studies; D012307:Risk Factors; D002583:Uterine Cervical Neoplasms / Q000473:pathology* / Q000601:surgery*
Cervical cancer; Less radical surgery; Magnetic resonance imaging; Parametrial involvement; Tumor diameter