The negative predictive value of clinical examination with or without anesthesia versus magnetic resonance imaging for parametrial infiltration in cervical cancer stages IB1 to IIA.

Publisher: BMJ Country of Publication: England NLM ID: 9111626 Publication Model: Print Cited Medium: Internet ISSN: 1525-1438 (Electronic) Linking ISSN: 1048891X NLM ISO Abbreviation: Int J Gynecol Cancer Subsets: MEDLINE

Publication: 2019- : [London] : BMJ
Original Publication: Cambridge, MA, USA : Blackwell Scientific Publications, c1991-

Anesthesia*/methods ; Diagnostic Techniques, Obstetrical and Gynecological* ; Magnetic Resonance Imaging*/methods; Carcinoma/*diagnosis ; Gynecological Examination/*methods ; Pelvic Floor/*pathology ; Uterine Cervical Neoplasms/*diagnosis; Adult ; Aged ; Algorithms ; Carcinoma/diagnostic imaging ; Carcinoma/pathology ; Cohort Studies ; Female ; Humans ; Middle Aged ; Neoplasm Invasiveness ; Neoplasm Staging ; Predictive Value of Tests ; Radiography ; Reproducibility of Results ; Retrospective Studies ; Uterine Cervical Neoplasms/diagnostic imaging ; Uterine Cervical Neoplasms/pathology ; Young Adult

Objective: This study aimed to compare the negative predictive value (NPV) of clinical examination with or without anesthesia and magnetic resonance imaging (MRI) in identifying patients with cervical carcinoma without parametrial infiltration.
Methods: This retrospective cohort study was conducted at the Academic Medical Center in Amsterdam. The medical files of 203 patients diagnosed with cervical cancer stages IB1-IIA, who underwent surgical treatment between January 1, 2003, and January 31, 2011, were reviewed. We compared clinical International Federation of Gynecology and Obstetrics staging and MRI during the staging procedure. The results were compared with the parametrial status by surgical-pathological investigation, which was considered to be the reference standard.
Results: Based on the surgical-pathological findings, 16.7% of the patients treated surgically had parametrial infiltration. For parametrial infiltration, examination under anesthesia (EUA) had an NPV of 65.3% and MRI of 76.9%, respectively. We found no significant difference between these NPVs.
Conclusions: Examination under anesthesia and MRI are equal in identifying cervical cancer patients without parametrial infiltration with a tendency for MRI to perform better than EUA. When outpatient clinical staging is considered inconclusive, pretreatment staging may be limited to MRI. In these cases, EUA seems to have no additional value.

Date Created: 20121211 Date Completed: 20130605 Latest Revision: 20220310

20231215

10.1097/IGC.0b013e31827a4ad8

23221736