Journal of South Asian Federation of Obstetrics and Gynaecology

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VOLUME 14 , ISSUE 1 ( January-February, 2022 ) > List of Articles

ORIGINAL RESEARCH

Preoperative Triage of Early Stage Operable Ca Cervix

Tony Jose, Raju Agarwal, Monica Saraswat

Keywords : Adjuvant radiotherapy, Carcinoma cervix, Depth of stromal invasion, Parametrial metastasis, Preoperative triage, Tumor diameter

Citation Information : Jose T, Agarwal R, Saraswat M. Preoperative Triage of Early Stage Operable Ca Cervix. J South Asian Feder Obs Gynae 2022; 14 (1):41-45.

DOI: 10.5005/jp-journals-10006-1995

License: CC BY-NC 4.0

Published Online: 13-04-2022

Copyright Statement:  Copyright © 2022; The Author(s).


Abstract

Aim: Carcinoma (Ca) cervix is staged clinically and early stages undergo radical hysterectomy but many cases need adjuvant radiotherapy (RT)-based on the high and intermediate risk factors on histopathology, thus increasing morbidity and cost. This study evaluated the role of preoperative MRI in triaging patients of early stage operable Ca cervix to identify patients likely to require adjuvant RT after surgery. Materials and methods: In total, 28 cases of operable Ca cervix clinically staged as I B1 underwent a preoperative MRI and based on the criteria of tumor size, depth of stromal invasion (DOSI), and parametrial involvement were triaged into low and high risk for receiving adjuvant treatment. They underwent radical hysterectomy and the specimen was subjected to pathologic examination. The pathologic characteristics and need for adjuvant treatment were studied. Results: MRI evaluation could accurately evaluate the tumor size and DOSI and parametrial metastasis in all cases of Stage B1 Ca cervix. Based on these risk criteria, the cases were triaged into low risk (13) and high risk (15) to predict the requirement of adjuvant treatment. There was a statistically significant difference in the requirement of adjuvant RT in the two risk groups (15.38 vs 66.66%). Conclusion: MRI can effectively estimate the tumor size and DOSI and parametrial metastasis in early stage (Stage I B1) Ca cervix and can further triage them to high- and low-risk groups to effectively predict the requirement of postoperative adjuvant RT. Clinical significance: Surgery could be avoided in patients likely to require adjuvant RT by this triage, thus reducing morbidity.


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