Tumoral volume measured preoperatively by magnetic resonance imaging is related to survival in endometrial cancer

Abstract

ABSTRACT

Objective: To determine if the tumor volume measured by magnetic resonance image (MRI-TV) is associated with survival in endometrial cancer and lymph nodes metastases (LN+).

Material and Methods: 341 women with EC and preoperative MRI were evaluated from 2008 to 2018. The MRI-TV was calculated using the ellipsoid formula measuring three perpendicular tumor diameters. Tumor myometrial invasion was also analyzed. Data from patient’s records was retrieved. 

Results: Higher MRI-TV was associated with an age ≥65y, non-endometrioid tumors, grade-3, deep-myometrial invasion, LN+, and advanced FIGO stage. There were 37 patients with LN+ (8.8%); non-endometrioid tumors, deep-myometrial invasion, grade-3, and MRI-TV ≥ 10 cm³ were the factors associated with LN+. Using a COR curve, the MRI-TV cut-off for survival was 10 cm³ (area under curve = 0.70; 95%CI: 0.61-0.73). 5y disease-free (DFS) and overall survival (OS) was significantly lower in MRI-TV ≥ 10 cm³ (69.3% vs 84.5%, and 75.4% vs 96.1% respectively). MRI-TV was considered an independent factor of DSF (HR: 2.20, 95%CI:1.09-4.45, p=0.029) and OS (HR: 3.88, 95%CI: 1.34-11.24, p = 0.012) in multivariant analysis.

Conclusion: MRV-TV is associated with LN+, and MRI-TV ≥ 10 cm³ is an independent prognostic factor of lower DFS and OS. The MRI-TV can be ancillary information to plan the surgery strategy and predict the adjuvant treatment in women with endometrial cancer.