Tumoral volume measured preoperatively by magnetic resonance imaging is related to survival in endometrial cancer

  • Pluvio Coronado Professor
  • Javier de Santiago-López Women’s Health Institute José Botella Llusiá of Hospital Clínico San Carlos. Fundación de Investigación del Hospital Clínico San Carlos (IdISSC). Universidad Complutense. Madrid, Spain
  • Javier de Santiago-García Service of Gynecology Oncology. MD Anderson Cancer Center Madrid, Spain
  • Ramiro Méndez Service of Radiology. Hospital Clínico San Carlos. Madrid, Spain
  • Maria Fasero Service of Obstetrics and Gynecology. Hospital Sanitas La Zarzuela. Universidad Francisco de Vitoria. Madrid, Spain
  • Miguel A. Herraiz Women’s Health Institute José Botella Llusiá of Hospital Clínico San Carlos. Fundación de Investigación del Hospital Clínico San Carlos (IdISSC). Universidad Complutense. Madrid, Spain.

Abstract

ABSTRACT

Objective: To determine if the tumor volume measured by magnetic resonance image (MRI-TV) is associated with survival in endometrial cancer and lymph nodes metastases (LN+).

Material and Methods: 341 women with EC and preoperative MRI were evaluated from 2008 to 2018. The MRI-TV was calculated using the ellipsoid formula measuring three perpendicular tumor diameters. Tumor myometrial invasion was also analyzed. Data from patient’s records was retrieved. 

Results: Higher MRI-TV was associated with an age ≥65y, non-endometrioid tumors, grade-3, deep-myometrial invasion, LN+, and advanced FIGO stage. There were 37 patients with LN+ (8.8%); non-endometrioid tumors, deep-myometrial invasion, grade-3, and MRI-TV ≥ 10 cm3 were the factors associated with LN+. Using a COR curve, the MRI-TV cut-off for survival was 10 cm3 (area under curve = 0.70; 95%CI: 0.61-0.73). 5y disease-free (DFS) and overall survival (OS) was significantly lower in MRI-TV ≥ 10 cm3 (69.3% vs 84.5%, and 75.4% vs 96.1% respectively). MRI-TV was considered an independent factor of DSF (HR: 2.20, 95%CI:1.09-4.45, p=0.029) and OS (HR: 3.88, 95%CI: 1.34-11.24, p = 0.012) in multivariant analysis.

Conclusion: MRV-TV is associated with LN+, and MRI-TV ≥ 10 cm3 is an independent prognostic factor of lower DFS and OS. The MRI-TV can be ancillary information to plan the surgery strategy and predict the adjuvant treatment in women with endometrial cancer.

Author Biographies

Javier de Santiago-García, Service of Gynecology Oncology. MD Anderson Cancer Center Madrid, Spain

Chair of Service 

Miguel A. Herraiz, Women’s Health Institute José Botella Llusiá of Hospital Clínico San Carlos. Fundación de Investigación del Hospital Clínico San Carlos (IdISSC). Universidad Complutense. Madrid, Spain.

Chari of the Service

Published
2021-02-15
How to Cite
Coronado, P., de Santiago-López, J., de Santiago-García, J., Méndez, R., Fasero, M., & Herraiz, M. (2021). Tumoral volume measured preoperatively by magnetic resonance imaging is related to survival in endometrial cancer. Radiology and Oncology, 55(1), 35-41. Retrieved from https://radioloncol.com/index.php/ro/article/view/3465
Section
Radiology