title: Pretreatment Mean Apparent Diffusion Coefficient Is Significantly Correlated With Event-Free Survival in Patients With International Federation of Gynecology and Obstetrics Stage Ib to IIIb Cervical Cancer.
abstract: OBJECTIVE
  To assess the prognostic impact of the pretreatment mean apparent diffusion coefficient (ADCmean) values of tumors obtained by diffusion-weighted magnetic resonance imaging. We evaluated the prognostic value of the ADCmean for event-free survival (EFS) and overall survival (OS) among patients with uterine cervical cancer.
  
  
  METHODS
  We included 171 patients diagnosed as having International Federation of Gynecology and Obstetrics stage Ib to IIIb cervical cancer by pretreatment magnetic resonance imaging scans, regardless of therapeutic methods. In all patients and in patients with squamous cell carcinoma (SCC; n = 123), the optimal cutoff values of the tumor ADCmean for EFS and for OS were determined, respectively. The prognostic significance of the ADCmean was evaluated using univariate and multivariate Cox regression analyses.
  
  
  RESULTS
  In the univariate analyses, the ADCmean values were significantly associated with negative effects on EFS both in all patients and in patients with SCC, while not being significantly associated with OS in both groups. In the multivariate analysis, ADCmean was an independent biomarker for EFS (P < 0.05) in patients with SCC along with lymph node metastasis and definitive surgery, whereas ADCmean was not independently significant in EFS in all patients.
  
  
  CONCLUSIONS
  The pretreatment ADCmean value of the tumor was an independent prognostic factor for EFS in International Federation of Gynecology and Obstetrics stage Ib to III SCC of the uterine cervix.
authors: Departments of *Diagnostic Imaging and Nuclear Medicine and †Gynecology and Obstetrics, Kyoto University Graduate School of Medicine, Kyoto, Japan; and ‡Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan.
authors: Yuki
authors: Y
authors: Himoto
authors: Koji
authors: K
authors: Fujimoto
authors: Aki
authors: A
authors: Kido
authors: Tsukasa
authors: T
authors: Baba
authors: Shiro
authors: S
authors: Tanaka
authors: Nobuko
authors: N
authors: Morisawa
authors: Sho
authors: S
authors: Koyasu
authors: Ikuo
authors: I
authors: Konishi
authors: Kaori
authors: K
authors: Togashi
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000556:secondary* / Q000628:therapy; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000556:secondary* / Q000628:therapy; D059248:Chemoradiotherapy / Q000401:mortality*; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008207:Lymphatic Metastasis; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D010386:Pelvic Neoplasms / Q000401:mortality / Q000556:secondary* / Q000628:therapy; D011379:Prognosis; D012189:Retrospective Studies; D012955:Societies, Medical; D015996:Survival Rate; D002583:Uterine Cervical Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy