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dc.contributor.authorYtre-Hauge, Sigmunden_US
dc.contributor.authorHusby, Jenny Hild Aaseen_US
dc.contributor.authorMagnussen, Inger Johanneen_US
dc.contributor.authorWerner, Henrica Maria Johannaen_US
dc.contributor.authorSalvesen, Øyvinden_US
dc.contributor.authorBjørge, Lineen_US
dc.contributor.authorTrovik, Joneen_US
dc.contributor.authorStefansson, Ingunnen_US
dc.contributor.authorSalvesen, Helga Birgitteen_US
dc.contributor.authorHaldorsen, Ingfrid S.en_US
dc.PublishedInternational Journal of Gynecological Cancer 2015, 25(3):459-466eng
dc.description.abstractOBJECTIVE: The aim of this study was to explore the relation between preoperative tumor size based on magnetic resonance imaging (MRI) and the surgical pathologic staging parameters (deep myometrial invasion, cervical stroma invasion, and metastatic lymph nodes) and to assess the prognostic impact of tumor size in endometrial carcinomas. Interobserver variability for the different tumor size measurements was also assessed. METHODS/MATERIALS: Preoperative pelvic MRI of 212 patients with histologically confirmed endometrial carcinomas was read independently by 3 radiologists. Maximum tumor diameters were measured in 3 orthogonal planes (anteroposterior, transverse, and craniocaudal planes [CC]), and tumor volumes were estimated. Tumor size was analyzed in relation to surgical staging results and patient survival. The multivariate analyses were adjusted for preoperative risk status based on endometrial biopsy. Intraclass correlation coefficients and receiver operating characteristics curves for the different tumor measurements were also calculated. RESULTS: Anteroposterior tumor diameter independently predicted deep myometrial invasion (P < 0.001), whereas CC tumor diameter tended to independently predict lymph node metastases (P = 0.06). Based on receiver operating characteristic curves, the following tumor size cutoff values were identified: anteroposterior diameter greater than 2 cm predicted deep myometrial invasion (unadjusted odds ratio [OR], 12.4; P < 0.001; adjusted OR, 6.7; P < 0.001) and CC diameter greater than 4 cm predicted lymph node metastases (unadjusted OR, 6.2; P < 0.001; adjusted OR, 4.9; P = 0.009). Large tumor size was associated with reduced progression/recurrence-free survival (P ≤ 0.005 for all size parameters), and CC diameter had an independent impact on survival (adjusted hazards ratio, 1.04; P = 0.009). The interobserver variability for the different size measurements was very low (intraclass correlation coefficient, 0.78-0.85). CONCLUSIONS: Anteroposterior tumor diameter greater than 2 cm predicts deep myometrial invasion, and CC tumor diameter greater than 4 cm predicts lymph node metastases. Tumor size is a strong prognostic factor in endometrial carcinomas. Preoperative tumor measurements based on MRI may potentially improve preoperative risk stratification models and thus enable better tailored surgical treatment in endometrial cancer.en_US
dc.publisherWolters Kluwereng
dc.relation.ispartof<a href="" target="blank">Functional imaging to promote individualized and targeted therapy in endometrial cancer</a>eng
dc.rightsAttribution CC BY-NC-ND 3.0eng
dc.subjectEndometrial carcinomaeng
dc.subjectTumor sizeeng
dc.subjectMagnetic resonance imagingeng
dc.titlePreoperative tumor size at MRI predicts deep myometrial invasion, lymph node metastases, and patient outcome in endometrial carcinomasen_US
dc.typePeer reviewed
dc.typeJournal article
dc.rights.holderCopyright 2015 by the International Gynecologic Cancer Society and the European Society of Gynaecological Oncology
dc.relation.projectNorges forskningsråd: 223250
dc.relation.projectNorges forskningsråd: 239840
dc.relation.projectNorges forskningsråd: 205404
dc.subject.nsiVDP::Medisinske fag: 700::Klinisk medisinske fag: 750::Onkologi: 762
dc.subject.nsiVDP::Midical sciences: 700::Clinical medical sciences: 750::Oncology: 762
dc.subject.nsiVDP::Medisinske Fag: 700::Klinisk medisinske fag: 750en_US

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