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Neoangiogenesis in early cervical cancer: correlation between color Doppler findings and risk factors. A prospective observational study.

Jurado M, Galván R, Martinez-Monge R, Mazaira J, Alcazar JL - World J Surg Oncol (2008)

Bottom Line: A total of 27 patients (mean age: 51.3 years, range: 29 to 85) with histologically proven early stage invasive cervical cancer were evaluated by TVCD prior to surgery.All patients underwent radical hysterectomy and pelvic lymph node dissection.The presence of scanty-moderate vascularization with a PI < 0.82 or abundant vascularization with either PI > 0.82 or PI < 0.82 was associated with high-risk group in 94.4% of the cases (OR: 21.2, 95% CI: 1.9 to 236.0) The results are consistent with a relationship between tumor angiogenesis and prognostic factors for recurrence in early cervical cancer. "Abundant" vascularization and PI < 0.82 may be related to postoperative treatment due to risk factors.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Gynecology, Clínica Universitaria de Navarra, School of Medicine, University of Navarra, Pamplona, Spain. mjurado@unav.es

ABSTRACT

Background: The aim of the present article was to evaluate whether angiogenic parameters as assessed by transvaginal color Doppler ultrasound (TVCD) may predict those prognostic factors related to recurrence.

Methods: A total of 27 patients (mean age: 51.3 years, range: 29 to 85) with histologically proven early stage invasive cervical cancer were evaluated by TVCD prior to surgery. Subjective assessment of the amount of vessels within the tumor (scanty-moderate or abundant) and pulsatility index (PI) were recorded. All patients underwent radical hysterectomy and pelvic lymph node dissection. Postoperative treatment (RT or chemoradiotherapy) was given according to risk factors (positive lymph nodes, parametrial and vaginal margin involvement, depth stromal invasion, lymph-vascular space involvement)

Results: Tumors with "abundant" vascularization were significantly associated with pelvic lymph node metastases, depth stromal invasion > 10 mm, lymph-vascular space involvement, tumor diameter > 17.5 mm, and parametrial involvement. Postoperative treatment was significantly more frequent in patients with "abundant" vascularization (OR: 20.8, 95% CIs: 2 to 211). The presence of scanty-moderate vascularization with a PI < 0.82 or abundant vascularization with either PI > 0.82 or PI < 0.82 was associated with high-risk group in 94.4% of the cases (OR: 21.2, 95% CI: 1.9 to 236.0)

Conclusion: The results are consistent with a relationship between tumor angiogenesis and prognostic factors for recurrence in early cervical cancer. "Abundant" vascularization and PI < 0.82 may be related to postoperative treatment due to risk factors.

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Transvaginal color Doppler ultrasound showing a cervical cancer with scanty vascularization.
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Figure 1: Transvaginal color Doppler ultrasound showing a cervical cancer with scanty vascularization.

Mentions: After tumor size was estimated, color Doppler gate was activated to identify intratumoral vessels. Color sensitivity was set for slow velocities (1.5–10 cm/sec. PRF was set at 6.0 kHz). Color gain was set at maximum level and then lowered until noise disappeared. As peripheral vessels could not be reliably ascertained as neovascularized or pre-existing vessels only central vessels were evaluated. We arbitrarily considered as "central vessels" those located at least at 5 mm far from the tumor's border. The amount of vascularization was subjectively stated as scanty/moderate (only few color spots seen) or abundant (multiple color spots seen) (Figures 1 and 2). After a vessel was identified, pulsed Doppler volume sample was activated to obtain the flow velocity waveform (FVW). Pulsatility index (PI = [maximum peak systolic velocity- end diastolic velocity]/mean velocity) was automatically calculated for each vessel. We chose PI arbitrarily. The lowest PI found was taken for analysis.


Neoangiogenesis in early cervical cancer: correlation between color Doppler findings and risk factors. A prospective observational study.

Jurado M, Galván R, Martinez-Monge R, Mazaira J, Alcazar JL - World J Surg Oncol (2008)

Transvaginal color Doppler ultrasound showing a cervical cancer with scanty vascularization.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2611993&req=5

Figure 1: Transvaginal color Doppler ultrasound showing a cervical cancer with scanty vascularization.
Mentions: After tumor size was estimated, color Doppler gate was activated to identify intratumoral vessels. Color sensitivity was set for slow velocities (1.5–10 cm/sec. PRF was set at 6.0 kHz). Color gain was set at maximum level and then lowered until noise disappeared. As peripheral vessels could not be reliably ascertained as neovascularized or pre-existing vessels only central vessels were evaluated. We arbitrarily considered as "central vessels" those located at least at 5 mm far from the tumor's border. The amount of vascularization was subjectively stated as scanty/moderate (only few color spots seen) or abundant (multiple color spots seen) (Figures 1 and 2). After a vessel was identified, pulsed Doppler volume sample was activated to obtain the flow velocity waveform (FVW). Pulsatility index (PI = [maximum peak systolic velocity- end diastolic velocity]/mean velocity) was automatically calculated for each vessel. We chose PI arbitrarily. The lowest PI found was taken for analysis.

Bottom Line: A total of 27 patients (mean age: 51.3 years, range: 29 to 85) with histologically proven early stage invasive cervical cancer were evaluated by TVCD prior to surgery.All patients underwent radical hysterectomy and pelvic lymph node dissection.The presence of scanty-moderate vascularization with a PI < 0.82 or abundant vascularization with either PI > 0.82 or PI < 0.82 was associated with high-risk group in 94.4% of the cases (OR: 21.2, 95% CI: 1.9 to 236.0) The results are consistent with a relationship between tumor angiogenesis and prognostic factors for recurrence in early cervical cancer. "Abundant" vascularization and PI < 0.82 may be related to postoperative treatment due to risk factors.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Gynecology, Clínica Universitaria de Navarra, School of Medicine, University of Navarra, Pamplona, Spain. mjurado@unav.es

ABSTRACT

Background: The aim of the present article was to evaluate whether angiogenic parameters as assessed by transvaginal color Doppler ultrasound (TVCD) may predict those prognostic factors related to recurrence.

Methods: A total of 27 patients (mean age: 51.3 years, range: 29 to 85) with histologically proven early stage invasive cervical cancer were evaluated by TVCD prior to surgery. Subjective assessment of the amount of vessels within the tumor (scanty-moderate or abundant) and pulsatility index (PI) were recorded. All patients underwent radical hysterectomy and pelvic lymph node dissection. Postoperative treatment (RT or chemoradiotherapy) was given according to risk factors (positive lymph nodes, parametrial and vaginal margin involvement, depth stromal invasion, lymph-vascular space involvement)

Results: Tumors with "abundant" vascularization were significantly associated with pelvic lymph node metastases, depth stromal invasion > 10 mm, lymph-vascular space involvement, tumor diameter > 17.5 mm, and parametrial involvement. Postoperative treatment was significantly more frequent in patients with "abundant" vascularization (OR: 20.8, 95% CIs: 2 to 211). The presence of scanty-moderate vascularization with a PI < 0.82 or abundant vascularization with either PI > 0.82 or PI < 0.82 was associated with high-risk group in 94.4% of the cases (OR: 21.2, 95% CI: 1.9 to 236.0)

Conclusion: The results are consistent with a relationship between tumor angiogenesis and prognostic factors for recurrence in early cervical cancer. "Abundant" vascularization and PI < 0.82 may be related to postoperative treatment due to risk factors.

Show MeSH
Related in: MedlinePlus