Transvaginal color Doppler for predicting pathological response to preoperative chemoradiation in locally advanced cervical carcinoma: a preliminary study
Alcázar JL, Jurado M.
Department of Obstetrics and Gynecology, Clínica Universitaria de Navarra, School of Medicine, Pamplona, Spain.
To evaluate the role of transvaginal color Doppler ultrasonography (TCD) in predicting pathological response to preoperative chemoradiation in patients with locally advanced cervical cancer, 10 patients (mean age: 45.2 y, range: 31 to 75 y) with histologically proven locally advanced cervical cancer who were scheduled for preoperative chemoradiation were evaluated by TCD prior to beginning the treatment protocol. Tumor volume, number of vessels within the tumor, lowest resistance index (RI), maximum peak systolic velocity (PSV), and the ratio between the number of vessels and tumor volume (tumor vascular density, TVD) were calculated.
All patients underwent preoperative chemoradiation and radical surgery. Complete pathological response (pathCR) was considered when no residual tumor was found on surgical specimens. Partial pathological response (pathPR) was considered when residual tumor was found. PathCR was achieved in three patients (30%), whereas 7 (70%) had pathPR. Mean tumoral volume was not statistically different between those with pathCR (33.2 cm3) and those with pathPR (20.3 cm3) (p = 0.305). Those tumors with pathCR had lower mean number of vessels (3.3 vs. 5.3, p = 0.01), lower TVD (0.1 vs. 1.1, p = 0.05) and higher RI (0.41 vs. 0.29, p = 0.03). No differences were found in PSV.
Although these data are preliminary, our results suggest that TCD may be used to predict pathological response to preoperative chemoradiation in patients with locally advanced cervical cancer.
CITATION Ultrasound Med Biol. 1999 Sep;25(7):1041-5