Tumor volume may help determine cervical cancer prognosis

VIENNA - Cervical cancer, along with ovarian cancer, is fast becoming one of the greatest killers of women on the European continent. Researchers here are working on a variety of diagnostic techniques and methodologies in order to improve the prognosis of women who develop these diseases.

In a presentation at this week’s European Congress of Radiology meeting, Dr. Rosemarie Forstner shared the results of an 11-year research project conducted by her and colleagues at LKS Salzburg and the University of Graz in Salzburg, Austria. The long-term project has sought to use tumor volume as a predictive factor of long-term prognosis in cervical cancer.

"Measurement of tumor size is not standardized and varies among different investigators," according to Forstner.

Her group began assessing tumor volume as a prognostic factor for overall survival of cervical cancer patients in 1988. Between that time and 1999, the researchers had performed histopathologic volume measurements on 122 patients with cervical cancer.

In addition to the histopathologic volumetric measurements, Forstner and her fellow researchers used MR to assess tumor volume. They performed scans on 99 patients using either a 1.5-tesla or 1-tesla unit to take both sagittal and axial T1- and T2-weighted images.

On 67 of the patients, the researchers also performed 3-D analysis volumetry to determine tumor size. In all the patients, the tumor size was calculated by the three maximum tumor diameters using the ellipsoid formula. The group then went about determining if there was a correlation between the tumor volumes by MR and histopathology.

The group reported that the two volume measurements assessed with MR and at histopathology correlated significantly. However, a difference was seen between the mean volumes in each method of volume assessment. Also, the authors observed, 3-D analysis volumetry tended to be larger at histopathology than MR using the flattened ellipsoid formula to determine volume.

Forstner noted that overall survival (five years being disease-free) was significantly influenced by the tumor volume, lymph node status, and tumor stage of the study’s patients. In fact, overall survival for tumor volumes was 94% for tumors less than 2.5 cm3; 78% for tumors of 2.5-10 cm3 78%, 69% for tumors 11-25 cm3, and 65% for tumors greater than 25 cm3, she said.

Forstner and her colleagues strongly support the use of their MR tumor volume techniques as part of the preoperative prognosis process for cervical cancer. However, she did caution ECR attendees that MR-determined tumor volumes tend to be larger than at histopathology.

By Jonathan S. Batchelor
AuntMinnie.com staff writer
March 6, 2001

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