Limits...
Identifying a low-risk group for parametrial involvement in microscopic Stage IB1 cervical cancer using criteria from ongoing studies and a new MRI criterion.

Lee JY, Youm J, Kim JW, Cho JY, Kim MA, Kim TH, Suh DH, Lim MC, Park NH, Song YS - BMC Cancer (2015)

Bottom Line: SHAPE and MRI criteria identified 78 (62.4%) and 74 (59.2%) patients, respectively, as less radical surgery candidates; 67 patients were identified as less radical surgery candidates by both sets of criteria.Of these 67 patients, only one had pathologic PMI with tumor emboli.This study suggests that the criteria used in three ongoing studies and a new, simplified criterion using MRI can identify candidates for less radical surgery with acceptable false negativity in microscopic Stage IB1 disease.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, Institute of Women's Medical Life Science, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, 120-752, Seoul, Korea. yodrum682@gmail.com.

ABSTRACT

Background: There are currently three ongoing studies on less radical surgery in cervical cancer: ConCerv, GOG-278, and SHAPE. The aim of this study was to evaluate the performance of the criteria used in ongoing studies retrospectively and suggest a new, simplified criterion in microscopic Stage IB1 cervical cancer.

Methods: A retrospective analysis was performed in 125 Stage IB1 cervical cancer patients who had no clinically visible lesions and were allotted based on microscopic findings after conization. All patients had magnetic resonance imaging (MRI) after conization and underwent type C2 radical hysterectomy. We suggested an MRI criterion for less radical surgery candidates as patients who had no demonstrable lesions on MRI. The rates of parametrial involvement (PMI) were estimated for patients that satisfied the inclusion criteria for ongoing studies and the MRI criterion.

Results: The rate of pathologic PMI was 5.6% (7/125) in the study population. ConCerv and GOG-278 identified 11 (8.8%) and 14 (11.2%) patients, respectively, as less radical surgery candidates, and there were no false negative cases. SHAPE and MRI criteria identified 78 (62.4%) and 74 (59.2%) patients, respectively, as less radical surgery candidates; 67 patients were identified as less radical surgery candidates by both sets of criteria. Of these 67 patients, only one had pathologic PMI with tumor emboli.

Conclusions: This study suggests that the criteria used in three ongoing studies and a new, simplified criterion using MRI can identify candidates for less radical surgery with acceptable false negativity in microscopic Stage IB1 disease.

Show MeSH

Related in: MedlinePlus

Distribution of less radical surgery candidates according to the various criteria. The area of square with gray per white is proportional to the number of less radical surgery candidates per study cohort. Study cohort, 100% (n = 125); ConCerv, 8.8% (n = 11); GOG-278, 11.2% (n = 14); SHAPE, 62.4% (n = 78); MRI, 59.2% (n = 74).
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
getmorefigures.php?uid=PMC4374417&req=5

Fig2: Distribution of less radical surgery candidates according to the various criteria. The area of square with gray per white is proportional to the number of less radical surgery candidates per study cohort. Study cohort, 100% (n = 125); ConCerv, 8.8% (n = 11); GOG-278, 11.2% (n = 14); SHAPE, 62.4% (n = 78); MRI, 59.2% (n = 74).

Mentions: We use a Venn diagram to show the candidates for less radical surgery and how they satisfying the various criteria (Figure 2). In our cohort, ConCerv criteria were the most conservative for identifying candidates for less radical surgery, and patients designated as low risk using Concerv criteria completely satisfied the GOG-278 criteria. In addition, patients assigned as low-risk based on the GOG-278 criteria completely satisfied the SHAPE and MRI criteria. By using the SHAPE criteria we would have identified more candidates for less radical surgery than by using the ConCerv or GOG-278 criteria. Furthermore, 67 patients satisfied the both SHAPE and MRI criteria. Of these 67 patients, only one patient had pathologic PMI. In this case, the hysterectomy specimens showed residual tumor and pelvic lymph node metastasis, despite no demonstrable lesions on post-conization MRI, and indicated only tumor emboli within the lymph vascular channels in the parametrial tissue. Only seven patients identified as low risk based on the MRI criterion (n = 74) did not meet the SHAPE criteria, and 11 patients identified as low risk by the SHAPE criteria (n = 78) did not satisfy the MRI criterion.Figure 2


Identifying a low-risk group for parametrial involvement in microscopic Stage IB1 cervical cancer using criteria from ongoing studies and a new MRI criterion.

Lee JY, Youm J, Kim JW, Cho JY, Kim MA, Kim TH, Suh DH, Lim MC, Park NH, Song YS - BMC Cancer (2015)

Distribution of less radical surgery candidates according to the various criteria. The area of square with gray per white is proportional to the number of less radical surgery candidates per study cohort. Study cohort, 100% (n = 125); ConCerv, 8.8% (n = 11); GOG-278, 11.2% (n = 14); SHAPE, 62.4% (n = 78); MRI, 59.2% (n = 74).
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4374417&req=5

Fig2: Distribution of less radical surgery candidates according to the various criteria. The area of square with gray per white is proportional to the number of less radical surgery candidates per study cohort. Study cohort, 100% (n = 125); ConCerv, 8.8% (n = 11); GOG-278, 11.2% (n = 14); SHAPE, 62.4% (n = 78); MRI, 59.2% (n = 74).
Mentions: We use a Venn diagram to show the candidates for less radical surgery and how they satisfying the various criteria (Figure 2). In our cohort, ConCerv criteria were the most conservative for identifying candidates for less radical surgery, and patients designated as low risk using Concerv criteria completely satisfied the GOG-278 criteria. In addition, patients assigned as low-risk based on the GOG-278 criteria completely satisfied the SHAPE and MRI criteria. By using the SHAPE criteria we would have identified more candidates for less radical surgery than by using the ConCerv or GOG-278 criteria. Furthermore, 67 patients satisfied the both SHAPE and MRI criteria. Of these 67 patients, only one patient had pathologic PMI. In this case, the hysterectomy specimens showed residual tumor and pelvic lymph node metastasis, despite no demonstrable lesions on post-conization MRI, and indicated only tumor emboli within the lymph vascular channels in the parametrial tissue. Only seven patients identified as low risk based on the MRI criterion (n = 74) did not meet the SHAPE criteria, and 11 patients identified as low risk by the SHAPE criteria (n = 78) did not satisfy the MRI criterion.Figure 2

Bottom Line: SHAPE and MRI criteria identified 78 (62.4%) and 74 (59.2%) patients, respectively, as less radical surgery candidates; 67 patients were identified as less radical surgery candidates by both sets of criteria.Of these 67 patients, only one had pathologic PMI with tumor emboli.This study suggests that the criteria used in three ongoing studies and a new, simplified criterion using MRI can identify candidates for less radical surgery with acceptable false negativity in microscopic Stage IB1 disease.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, Institute of Women's Medical Life Science, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, 120-752, Seoul, Korea. yodrum682@gmail.com.

ABSTRACT

Background: There are currently three ongoing studies on less radical surgery in cervical cancer: ConCerv, GOG-278, and SHAPE. The aim of this study was to evaluate the performance of the criteria used in ongoing studies retrospectively and suggest a new, simplified criterion in microscopic Stage IB1 cervical cancer.

Methods: A retrospective analysis was performed in 125 Stage IB1 cervical cancer patients who had no clinically visible lesions and were allotted based on microscopic findings after conization. All patients had magnetic resonance imaging (MRI) after conization and underwent type C2 radical hysterectomy. We suggested an MRI criterion for less radical surgery candidates as patients who had no demonstrable lesions on MRI. The rates of parametrial involvement (PMI) were estimated for patients that satisfied the inclusion criteria for ongoing studies and the MRI criterion.

Results: The rate of pathologic PMI was 5.6% (7/125) in the study population. ConCerv and GOG-278 identified 11 (8.8%) and 14 (11.2%) patients, respectively, as less radical surgery candidates, and there were no false negative cases. SHAPE and MRI criteria identified 78 (62.4%) and 74 (59.2%) patients, respectively, as less radical surgery candidates; 67 patients were identified as less radical surgery candidates by both sets of criteria. Of these 67 patients, only one had pathologic PMI with tumor emboli.

Conclusions: This study suggests that the criteria used in three ongoing studies and a new, simplified criterion using MRI can identify candidates for less radical surgery with acceptable false negativity in microscopic Stage IB1 disease.

Show MeSH
Related in: MedlinePlus