title: Peritumoral interstitial fluid flow velocity predicts survival in cervical carcinoma.
abstract: OBJECTIVE
  High tumor interstitial fluid pressure (IFP) is associated with poor outcome in locally advanced carcinoma of the uterine cervix. We have recently developed a noninvasive assay of the IFP of tumors, and in this assay, the outward interstitial fluid flow velocity at the tumor surface (v0) is measured by Gd-DTPA-based DCE-MRI and used as a parameter for IFP. Here, we investigated the independent prognostic significance of v0 in cervical cancer patients given cisplatin-based concurrent chemoradiotherapy with curative intent.
  
  
  METHODS
  The study involved 62 evaluable patients from a cohort of 74 consecutive patients (Stage IB through IIIB) with a median follow-up of 5.5 years.
  
  
  RESULTS
  The actuarial disease-free survival (DFS) and overall survival (OS) at 5 years were 67% and 76%, respectively. Significant associations were found between v0 dichotomized about the median value and DFS and OS, both in the total patient cohort and a subcohort of 40 Stage IIB patients. Multivariate analysis involving stage, tumor volume, lymph node status, and v0 revealed that only v0 provided independent prognostic information about DFS and OS.
  
  
  CONCLUSIONS
  This investigation demonstrates a strong, independent prognostic impact of the pretreatment peritumoral fluid flow velocity in cervical cancer.
authors.affiliation: Department of Radiation Biology, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway.
authors.forename: Tord
authors.initials: T
authors.lastname: Hompland
authors.affiliation: Department of Radiation Biology, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway; Department of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway.
authors.forename: Kjersti V
authors.initials: KV
authors.lastname: Lund
authors.affiliation: Department of Radiation Biology, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway.
authors.forename: Christine
authors.initials: C
authors.lastname: Ellingsen
authors.affiliation: Department of Gynecological Cancer, Oslo University Hospital, Oslo, Norway; Institute for Medical Informatics, Oslo University Hospital, Oslo, Norway.
authors.forename: Gunnar B
authors.initials: GB
authors.lastname: Kristensen
authors.affiliation: Department of Radiation Biology, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway. Electronic address: einar.k.rofstad@rr-research.no.
authors.forename: Einar K
authors.initials: EK
authors.lastname: Rofstad
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D059248:Chemoradiotherapy / Q000379:methods*; D002945:Cisplatin / Q000627:therapeutic use; D003287:Contrast Media; D018572:Disease-Free Survival; D045604:Extracellular Fluid / Q000502:physiology*; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D008207:Lymphatic Metastasis; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D015999:Multivariate Analysis; D011312:Pressure; D011379:Prognosis; D047368:Tumor Burden; D002583:Uterine Cervical Neoplasms / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*
chemical_list: D000970:Antineoplastic Agents; D003287:Contrast Media; D019786:Gadolinium DTPA; D002945:Cisplatin
keywords: Cervical carcinoma; DCE-MRI; Disease-free and overall survival; Interstitial fluid pressure; Peritumoral fluid flow