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- Title
Prognostic model based on magnetic resonance imaging, whole-tumour apparent diffusion coefficient values and HPV genotyping for stage IB-IV cervical cancer patients following chemoradiotherapy.
- Authors
Lin, Gigin; Yang, Lan-Yan; Lin, Yu-Chun; Huang, Yu-Ting; Liu, Feng-Yuan; Wang, Chun-Chieh; Lu, Hsin-Ying; Chiang, Hsin-Ju; Chen, Yu-Ruei; Wu, Ren-Chin; Ng, Koon-Kwan; Hong, Ji-Hong; Yen, Tzu-Chen; Lai, Chyong-Huey
- Abstract
<bold>Objectives: </bold>To develop and validate a prognostic model of integrating whole-tumour apparent diffusion coefficient (ADC) from pretreatment diffusion-weighted (DW) magnetic resonance (MR) imaging with human papillomavirus (HPV) genotyping in predicting the overall survival (OS) and disease-free survival (DFS) for women with stage IB-IV cervical cancer following concurrent chemoradiotherapy (CCRT).<bold>Methods: </bold>We retrospectively analysed three prospectively collected cohorts comprising 300 patients with stage IB-IV cervical cancer treated with CCRT in 2007-2014 and filtered 134 female patients who underwent MR imaging at 3.0 T for final analysis (age, 24-92 years; median, 54 years). Univariate and multivariate Cox regression analyses were used to evaluate the whole-tumour ADC histogram parameters, HPV genotyping and relevant clinical variables in predicting OS and DFS. The dataset was randomly split into training (n = 88) and testing (n = 46) datasets for construction and independent bootstrap validation of the models.<bold>Results: </bold>The median follow-up time for surviving patients was 69 months (range, 9-126 months). Non-squamous cell type, ADC10 <0.77 × 10-3 mm2/s, T3-4, M1 stage and high-risk HPV status were selected to generate a model, in which the OS and DFS for the low, intermediate and high-risk groups were significantly stratified (p < 0.0001). The prognostic model improved the prediction significantly compared with the International Federation of Gynaecology and Obstetrics (FIGO) stage for both the training and independent testing datasets (p < 0.0001).<bold>Conclusions: </bold>The prognostic model based on integrated clinical and imaging data could be a useful clinical biomarker to predict OS and DFS in patients with stage IB-IV cervical cancer treated with CCRT.<bold>Key Points: </bold>• ADC 10 is the best prognostic factor among ADC parameters in cervical cancer treated with CCRT • A novel prognostic model was built based on histology, ADC 10 , T and M stage and HPV status • The prognostic model outperforms FIGO stage in the survival prediction.
- Subjects
CERVICAL cancer; RADIOTHERAPY; GENOTYPE-environment interaction; CANCER chemotherapy; MAGNETIC resonance imaging
- Publication
European Radiology, 2019, Vol 29, Issue 2, p556
- ISSN
0938-7994
- Publication type
journal article
- DOI
10.1007/s00330-018-5651-4