Measurement of tumour volume by MRI to evaluate risk of pelvic nodal metastases in early cervical carcinoma patients

Abstract

Background

Apart from the FIGO staging system there are several other factors, including tumour volume and lymph node status, which considerably influence local tumour control and survival of cervical carcinoma patients.

Aim

The study aimed to determine the prognostic value of cervical tumour volume measured on the basis of MRI in terms of pelvic nodal metastases prediction in early cervical carcinoma patients.

Methods

The records of 49 early stage cervical carcinoma patients treated with preoperative brachytherapy and radical hysterectomy were analyzed. All patients underwent diagnostic MRI, which was the basis for tumour volume calculations as well as the evaluation of pelvic lymph nodes status and parametrial invasion. In each case the postoperative pathological diagnosis was obtained. The correlation between the occurrence of nodal metastases and such variables as tumour histology, grade and tumour volume, FIGOMRI stage IIB, and patients' age was evaluated. Logistic regression analysis was employed to determine correlations between tumour volume and histological pelvic nodal involvement.

Results

A statistically significant correlation between pelvic lymph node involvement and such parameters as tumour volume and parametrial invasion was proven. The probability of lymph node metastasis is 20% for tumour volume of 17 cm³ and increases up to 50% for tumour volume of 40 cm³. An increase of tumour volume by 1 cm³ increased the risk of lymph node disease by 6.2%.

Conclusions

The study demonstrates that tumour volume may be considered a predicting factor in early cervical carcinoma patients, since it strongly correlates with pelvic lymph node histological status.