Carcinoma of the cervix. Correlations between MR staging and prognosis

In 110 patients with cervical cancer, correlations between pretreatment MR findings and 5-year prognoses were analyzed. MR findings were classified according to clinical staging criteria of the Japan Society of Obstetrics and Gynecology. In 75 patients, staging by MR and that by conventional clinical methods agreed with surgical findings in 51 (68%) cases each, was overestimated in 5 (7%) and 16 (21%), and underestimated in 19 (25%) and 8 (11%), respectively. None of 41 patients without high-intensity areas (HIA) in the cervix on MR developed recurrence, but 26 of 69 (38%) with HIA relapsed. Two of 67 (3%) patients with MR stage IIa or lower developed recurrence, but 24 of 43 (56%) with stage IIb or higher relapsed. Among 26 patients with poor prognoses, 2 of 11 (18%) with stage IIb or lower, versus 9 of 15 (60%) with stage IIIb or higher disease detected by MR had distant metastases. Among 22 patients with MR stage IIb disease, local and distant recurrence occurred in 6 and 2 (50%, 17%) of 12 patients who underwent radical hysterectomy, versus 1 and none (10%, 0%) of 10 who received definitive radiotherapy. Fifteen of 95 (16%) patients without lymph node swelling greater that 1.5 cm on MR developed recurrence, while 11 of 15 (73%) patients with lymphadenopathy relapsed. MR is valuable not only in staging cervical cancer but also in assessing the risk of recurrence. (author)