Faculty Collaboration Database

The value of perioperative imaging in patients with uterine sarcomas. Gynecol Oncol 2009 Oct;115(1):37-40

Date

07/07/2009

Pubmed ID

19577795

Pubmed Central ID

PMC4306556

DOI

10.1016/j.ygyno.2009.06.013

Scopus ID

2-s2.0-69249221264 (requires institutional sign-in at Scopus site)   9 Citations

Abstract

OBJECTIVE: To explore the yield and impact of perioperative imaging on management among patients undergoing surgical resection and treatment of uterine sarcomas.

METHODS: A retrospective chart review was done for women with histologically confirmed uterine sarcomas treated at Barnes Jewish Hospital/Washington University from 2001 to 2007. Descriptive statistics, Cox multivariate models, and Kaplan-Meier plots were used to evaluate associations and survival.

RESULTS: A total of 92 patients were identified and 55 (60%) were diagnosed with stage III-IV disease. Perioperative imaging was obtained in 84 (91%) cases, including chest X-ray in 66 (72%), computerized tomography (CT) of the abdomen and pelvis in 59 (64%), chest CT in 33 (36%), positron emission tomography (PET) in 8 (9%), and CT of the head, pelvic magnetic resonance imaging (MRI), or bone scan in a total of 2 (2.2%). Imaging identified abnormalities concerning for metastases in 30 (32%) studies. Thirty-four recurrences have been documented, and 21 (62%) of these treatment failures were extrapelvic. Multivariate analysis of this series noted that tomographic evidence of extrauterine disease predicted recurrence (p=0.028) and incomplete surgical resection (p=0.003, HR 6.0 95% CI 1.9-19.9) predicted disease-free survival. Imaging contributed to change in surgical and post-surgical treatment decisions in 8 (9%) patients.

CONCLUSION: Pretreatment imaging studies change management in a minority of patients with newly diagnosed uterine sarcomas.

Author List

Nugent EK, Zighelboim I, Case AS, Gao F, Thaker PH, Rader JS, Mutch DG, Massad LS

Author

Janet Sue Rader MD Chair, Professor in the Obstetrics and Gynecology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Aged, 80 and over
Diagnostic Imaging
Female
Humans
Magnetic Resonance Imaging
Middle Aged
Neoplasm Staging
Perioperative Care
Positron-Emission Tomography
Retrospective Studies
Sarcoma
Tomography, X-Ray Computed
Uterine Neoplasms
Young Adult