Diagnostic significance of ultrasound and magnetic resonance imaging scan in the presurgical determination of FIGO stage of endometrial cancer.

PURPOSE: To compare the presurgically determined FIGO (Federation International Gynaecology Obstetrics) stage of endometrial cancer based on ultrasound (US) and magnetic resonance imaging (MRI) with the surgico-pathological disease stage. METHODS: 60 patients with histopathologically proven endometrial cancer were prospectively studied. Prior to surgical treatment, all patients underwent abdominal US and MRI. The imaging results were compared with the surgical histopathological findings. RESULTS: Imaging (US, MRI) staging accuracy for stage I identification was higher than the accuracy of advanced FIGO stages of endometrial cancer. Total accuracy of determination of all disease stages was significantly higher using MRI. CONCLUSION: US is not adequate for overall presurgical FIGO stage assessment, but does have satisfactory accuracy in determining tumor spread in the uterus itself and can be applied when MRI scanner is not available and when the risk of extrauterine disease expansion is low. MRI examination should be applied in all cases when there is suspicion for extrauterine spread into other pelvic and abdominal organs.

Linear trend analysis of patients with cervical cancer treated at the Institute of Oncology Vojvodina in 2001-2007.

PURPOSE: Cervical cancer is the leading cause of death in women with gynecological cancers in Vojvodina. Serbia currently holds the leading place in Europe regarding the incidence of cervical carcinoma and comes second in terms of mortality. METHODS: Data were retrieved from the Register for malignant neoplasms of the Institute of Oncology Vojvodina for the period 2001-2007. The patients were divided in 3 groups according to the stage of disease based on the FIGO classification for cervical cancer. Data were analysed using linear trend and t-test. RESULTS: The linear trend of the number of registered cases in the group of stage I-IIA patients during 7 years showed no significant change in the prevalence of the disease. In the group of women diagnosed with stage IIB no statistical difference regarding either a rising or a decreasing trend was observed. The observed trend in an advanced disease stage (III and IV) showed a slight decrease in the number of patients, but without statistical significance. CONCLUSION: The linear trend of the number of patients with cervical carcinoma during a 7-year period points to the fact that the number of newly detected cases of advanced disease stages did not decrease significantly despite the affordable and simple methods of early detection. This result underlines the importance of implementation of a National screening programme in the general population for early detection of cervical neoplasms. The excellent results of National screening programmes in other European countries lend support to this approach.

Radical hysterectomy for stage IB1 cervical carcinoma: lymph node metastasis as a prognostic factor.

PURPOSE: Lymph node metastasis is one of the most important factors influencing prognosis and further therapy in patients with cervical carcinoma. The aim of this study was to confirm the impact of nodal metastasis od disease-free interval in women with stage IB1 cancer of the uterine cervix. PATIENTS AND METHODS: From June 1986 to December 1999 269 patients with stage IB1 cervical carcinoma were operated on. Two hundred thirty-six (87.84%) patients had class III and 33 (12.16%) class II radical hysterectomy, according to Piver's classification. RESULTS: The median number of the removed lymph nodes was 21. Positive lymph nodes were found in 71 (25.28%) patients. All patients with positive lymph nodes received postoperative adjuvant external beam radiotherapy. Patients with bulky nodal disease received also chemotherapy.Overall 5-year disease-free interval in 212 patients was 80%. Five-year disease-free interval for patients without lymph node metastasis was 91%, while it was 40% in those with lymph node metastasis (p < 0.0001). CONCLUSION: Surgical staging of cervical cancer, which includes pelvic and para-aortic lymphadenectomy,together with pathological data, can provide potentially useful information for the radiation oncologist and precise analysis of survival and prognostic risk factors.