KEY TAKEAWAYS
- An observational SENTIX study compared MRI and EUS for preoperative staging in early cervical cancer without PLND.
- Pelvic MRI and EUS showed comparable sensitivity in preoperative clinical staging of cervical cancer
In early-stage cervical cancer, surgeons typically perform both sentinel lymph node (SLN) biopsy and pelvic lymph node dissection (PLND) to assess lymph node spread. PLND can have side effects like lymphedema.
For this study, researchers aimed to compare MRI and EUS for preoperative staging in early cervical cancer without PLND.
About 47 sites across 18 countries enrolled patients with stages 1A1/LVSI+ to 1B2 (FIGO 2018) cervical cancer, usual histological types, and no suspicious lymph nodes on imaging between May 2016 and October 2020. The preoperative local staging was performed using pelvic MRI or EUS, chosen at the investigator’s discretion.
Of 690 patients meeting inclusion criteria, 46.7% and 43.1% underwent pelvic MRI and EUS, respectively, with 10.1% undergoing both. Pathology revealed preoperatively unrecognized parametrial involvement in 3.8% and SLN metastatic involvement in 9.9% of patients, with 54.4% having micrometastasis and 45.6% macrometastasis as the largest type. MRI and EUS exhibited comparable sensitivity for tumor size measurement and detecting parametrial or macrometastatic LN involvement. Combining both imaging methods did not improve outcomes.
The results revealed that the pelvic MRI and EUS offer comparable accuracy for crucial preoperative cervical cancer staging parameters.
Source: https://www.emma.events/site/programme/?sessiondetail=4534540&trackid=0&a=esgo2023#!
Clinical Trial: https://clinicaltrials.gov/study/NCT02494063
Kocián R, Siegler K, Klát J, Benešová K, Paderno M, Lonkhuijzen LV, Chaloupková B, Pilka R, Michal M, Kašcák P, Kridelka F, Pakiž M, Snyman LC, Barahona M, Sawicki S, Blecharz P, Redecha M, Tóth R, Cibula D, Köhler C; SENTIX Trial Group. Magnetic Resonance Imaging Or Expert Ultrasound In Preoperative Local Staging Of Patients With Early-Stage Cervical Cancer: Final Results Of The SENTIX Prospective, Single-Arm, International Trial (CEEGOG CX-01; ENGOT-CX2). ESGO 2023 Congress; September 28 – October 1; Abstract #451.
