Yang Kyungmi, Park Won, Huh Seung Jae, Park Byung Kwan, Kim Chan Kyo, Kim Byoung-Gie, Bae Duk-Soo, Lee Jeong-Won
Departments of *Radiation Oncology, †Radiology, and ‡Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Korea.
Int J Gynecol Cancer. 2017 Mar;27(3):507-513. doi: 10.1097/IGC.0000000000000909.
Parametrial involvement (PMI) in patients with cervical cancer is known to be an unfavourable prognostic factor. The purpose of this study was to investigate the prognostic significance of PMI on magnetic resonance imaging (MRI) in patients with early-stage cervical cancer.
Three hundred three patients with stage IB or IIA cervical cancer treated by adjuvant radiotherapy or concurrent chemoradiotherapy following primary surgery from 2001 to 2011 were enrolled in this study. We reviewed preoperative MRI and pathologic findings and compared recurrence and survival of group defined according to PMI status.
There were 73 patients (24.1%) with PMI based on MRI and 52 patients (17.2%) with PMI based on surgical pathology. The accuracy of MRI for detecting PMI was 77.2% (sensitivity, 53.8%; specificity, 82.1%). In all patients, pathology-based evidence of PMI had a negative effect on both 5-year disease-free survival (73.2% vs 85.3%, P = 0.048) and 5-year overall survival (76.6% vs 91.4%, P = 0.009), but PMI on MRI did not have a significant effect on survival. In subgroups defined according to PMI status on MRI and surgical pathology, subgroups with pathology-based evidence of PMI showed a trend of a lower survival rate, regardless of PMI on MRI, but without statistical significance.
Unlike pathologic results, PMI on MRI was not associated with recurrence or survival in patients with early-stage cervical cancer.
已知宫颈癌患者的宫旁组织受累（PMI）是一个不良预后因素。本研究的目的是探讨早期宫颈癌患者MRI上PMI的预后意义。
纳入2001年至2011年期间接受初次手术后辅助放疗或同步放化疗的303例IB期或IIA期宫颈癌患者。我们回顾了术前MRI和病理结果，并比较了根据PMI状态定义的组的复发和生存情况。
基于MRI有73例患者（24.1%）存在PMI，基于手术病理有52例患者（17.2%）存在PMI。MRI检测PMI的准确性为77.2%（敏感性为53.8%；特异性为82.1%）。在所有患者中，基于病理的PMI证据对5年无病生存率（73.2%对85.3%，P = 0.048）和5年总生存率（76.6%对91.4%，P = 0.009）均有负面影响，但MRI上的PMI对生存无显著影响。在根据MRI和手术病理上的PMI状态定义的亚组中，基于病理有PMI证据的亚组无论MRI上是否有PMI均显示出生存率较低的趋势，但无统计学意义。
与病理结果不同，早期宫颈癌患者MRI上的PMI与复发或生存无关。
