Preoperative prediction of the need for postoperative adjuvant therapy in stage IB cervical cancer using tumor size measured on magnetic resonance imaging and serum squamous cell carcinoma antigen levels

IF 2.7

AJOG global reports Pub Date : 2026-08-01 Epub Date: 2026-06-28 DOI:10.1016/j.xagr.2026.100671

Michihide Maeda MD, PhD, Miho Kitai MD, Masashi Akada MD, Yusaku Shimizu MD, Eri Yamabe MD, Reisa Kakubari MD, Shinya Matsuzaki MD, PhD, Tsuyoshi Hisa MD, Shinsuke Koyama MD, PhD, Seiji Mabuchi MD, PhD

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Abstract

OBJECTIVE

Radical hysterectomy is widely performed for stage IB cervical cancer; however, a substantial number of patients require postoperative adjuvant therapy, resulting in dual-modality treatment. This study evaluated the predictive value of tumor size measured on magnetic resonance imaging (MRI) and serum squamous cell carcinoma (SCC) antigen levels for the need for postoperative adjuvant therapy.

METHODS

We retrospectively analyzed 191 patients with stage IB cervical SCC who underwent radical hysterectomy. Patients were also analyzed in a stage IB1 to IB2 cohort. The cut-off values of preoperative tumor size measured on MRI and serum SCC antigen levels for the need for postoperative adjuvant therapy were determined using receiver operating characteristic curve analysis.

RESULTS

A total of 104 patients (54.5%) received postoperative adjuvant therapy. Large tumor size measured on MRI and elevated serum SCC antigen levels were predictors of the need for postoperative adjuvant therapy. The optimal cut-off values were 3.2 cm and 2.3 ng/mL in the overall cohort, and 2.4 cm and 2.3 ng/mL in the stage IB1 to IB2 cohort. Patients were stratified into three risk groups according to the number of predictive factors. In the low-risk group (no predictors), 20 of 86 patients (23.3%) required postoperative adjuvant therapy. In the intermediate-risk group (one predictor), 46 of 64 patients (71.9%) required adjuvant therapy. In the high-risk group (two predictors), 38 of 41 patients (92.7%) received adjuvant therapy. Similar trends were observed in the stage IB1 to IB2 cohort, with increasing rates of adjuvant therapy across risk groups.

CONCLUSION

Preoperative tumor size measured on MRI and serum SCC antigen levels are useful predictors of the need for postoperative adjuvant therapy in stage IB cervical SCC. Their combination could assist in treatment planning and patient counseling.

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利用磁共振成像测量肿瘤大小和血清鳞状细胞癌抗原水平预测IB期宫颈癌术后辅助治疗的必要性

目的：IB期宫颈癌普遍采用根治性子宫切除术；然而，相当数量的患者需要术后辅助治疗，导致双模治疗。本研究评估了磁共振成像（MRI）测量的肿瘤大小和血清鳞状细胞癌（SCC）抗原水平对术后辅助治疗需求的预测价值。方法回顾性分析191例行根治性子宫切除术的IB期宫颈鳞状细胞癌患者。患者也被分析为IB1至IB2期队列。术前MRI测量的肿瘤大小和血清SCC抗原水平的临界值用于术后辅助治疗的需要，采用受试者工作特征曲线分析确定。结果104例患者（54.5%）接受了术后辅助治疗。MRI测量的大肿瘤大小和血清SCC抗原水平升高是需要术后辅助治疗的预测因素。最佳临界值在整个队列中为3.2 cm和2.3 ng/mL，在IB1至IB2期队列中为2.4 cm和2.3 ng/mL。根据预测因素的数量将患者分为三个危险组。在低危组（无预测因子），86例患者中有20例（23.3%）需要术后辅助治疗。在中危组（一个预测因子），64例患者中有46例（71.9%）需要辅助治疗。在高危组（两个预测因子）中，41例患者中有38例（92.7%）接受了辅助治疗。在IB1期至IB2期队列中也观察到类似的趋势，各个危险组的辅助治疗率都在增加。结论术前MRI测量肿瘤大小和血清SCC抗原水平是预测IB期宫颈SCC术后是否需要辅助治疗的有效指标。他们的结合可以帮助制定治疗计划和患者咨询。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

AJOG global reports Endocrinology, Diabetes and Metabolism, Obstetrics, Gynecology and Women's Health, Perinatology, Pediatrics and Child Health, Urology

CiteScore

1.20

自引率

0.00%

发文量