Correlation between tumor size and surveillance of lymph node metastasis for IB and IIA cervical cancer by magnetic resonance images

Abstract

Purpose: To assess the feasibility of preoperative MRI based measurement of tumor size with regard to lymph node (LN) metastasis in early uterine cervical cancer.

Material and methods: A retrospective review of patients with FIGO stage IB-IIA cervical cancer who underwent lymphadenectomy was performed. Diagnostic accuracy of MRI in detecting LN metastasis and rate of LN recurrence in terms of tumor size (≤4cm versus >4cm) were analyzed. ROC curve analysis was used to determine LN size for differentiating LN metastasis in terms of tumor size. P<0.05 was considered statistically significant.

Results: Of the 200 patients, 45 (22.3%) had LN metastasis. There was no statistical difference between patients-based and region-specific analysis. The patients with tumor size with >4cm revealed higher diagnostic accuracy of MRI in detecting LN metastasis (85.4% versus 50.6%, P=0.023) and rate of LN recurrence (20.0% versus 6.4%, P=0.031) in than those with size with ≤4cm, the differences were statistically significant. Discriminant analysis of LN size for the differentiation of metastasis from non-metastasis resulted in cut-off values (11.8mm; size with >4cm versus 8.3mm; size with ≤4cm) and diagnostic accuracy (84.0% of size with >4cm versus 72.0% of size with ≤4cm).

Conclusion: MRI has limited sensitivity, but high specificity in predicting surveillance of LN metastasis in the preoperative early cervical cancer, especially useful tool for patients with tumor size with >4cm.