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- Title
An Alternative Triage Strategy Based on Preoperative MRI for Avoiding Trimodality Therapy in Stage IB Cervical Cancer.
- Authors
Jung-Yun Lee; Jina Youm; Jae Weon Kim; Kidong Kim; Hak Jae Kim; Jeong Yeon Cho; Min A Kim; Noh Hyun Park; Yong-Sang Song
- Abstract
Purpose Adjuvant chemoradiation following primary surgery is frequently indicated in patients with stage IB cervical cancer. The aim of this study is to evaluate the role of a magnetic resonance imaging (MRI)-based strategy in avoiding trimodality therapy. Materials and Methods We retrospectively reviewed all patients with stage IB cervical cancer treated initially with primary surgery at Seoul National University Hospital. We suggest an alternative triage strategy in which the primary treatment modality is determined based on preoperative MRI findings. Using this strategy, primary surgery is only indicated when there is no evidence of parametrial involvement (PMI) and lymph node metastasis (LNM) in the MRI results; when there is evidence of either or both of these factors, primary chemoradiation is selected. Assuming that this strategy is applied to our cohort, we evaluate how the rate of trimodality therapy is affected. Results Of the 254 patients in our sample, 77 (30.3%) had at least one category 1 risk factor (PMI, LNM, positive resection margin) upon pathologic examination. If the MRI-based strategy had been applied to our cohort, 168 patients would have undergone primary surgery and 86 would have undergone primary chemoradiation. Only 25 patients (9.8%) would have required trimodality therapy based on an indication of at least one category 1 pathologic risk factor following radical hysterectomy. Conclusion The inclusion of MRI in the decision-making process for primary treatment modality could have reduced the number of patients requiring trimodality therapy based on the indication of a category 1 risk factor from 30.3% to 9.8% in our cohort.
- Subjects
MEDICAL triage; MAGNETIC resonance imaging; CERVICAL cancer treatment; LYMPH nodes; SOUL Taehakkyo
- Publication
Cancer Research & Treatment, 2016, Vol 48, Issue 1, p259
- ISSN
1598-2998
- Publication type
Article
- DOI
10.4143/crt.2014.370