Role of X-ray computed tomography in the evaluation of prognosis of cervical carcinoma

In 129 patients with cervical cancer, CT findings before treatment were analysed on the basis of the outcome during a 5 year follow-up period (75 survivals, and 54 deaths). The incidence of each CT finding in the two groups was as follows. (1) enlargement of the uterine cervix in 40.0% for survivals and 64.8% for deaths; (2) low density area in the cervix in 18.7% and 37.0%; (3) necrotic cavity in 4.0% and 33.3%; (4) pyometra in 8.0% and 31.5%; (5) irregular and indistinct margin of the cervix in 2.7% and 51.9%; (6) abnormal image of parametrium in 25.3% and 87.0%; (7) extension to the vagina in 2.7% and 37.0%; (8) extension toward the bladder in 8.0% and 57.4%; and (9) enlarged lymph node in 0% and 27.8%. CT scores obtained by multivariate analysis for prognostic discrimination of cervical cancer were +1 for (1), -1 for (2), +1 for (3), -3 for (4), +25 for (5), type B +29, C +25, D +10 for (6), +2 for (7), grade I +12, II +7, III +20 for (8), and +18 for (9). The discrimination ratio for the prognosis of cervical cancer was 82.9%. The score obtained by multivariate analysis showed significant increases according with the stage. Even in the same stage, there were significant differences between the scores for survivals and deaths (stage II: p<0.01, stage III: p<0.05). The survival period in the poor prognosis group was correlated with the score, especially when treated with radiotherapy (r=-0.45, p<0.01). (author)