Evaluation of tumor size in cervix cancer patients treated with surgery: ultrasonography or MRI?

Objective: This study aims to compare tumor diameters measured by transvaginal ultrasonography and MRI in cervical cancer. Materials and methods: The study includes 127 cervical cancer patients diagnosed and treated at Akdeniz University Faculty of Medicine between January 2002 and December 2019. Data were collected retrospectively using the electronic archive system of the hospital. Patients with pathologically unknown tumor diameters were excluded from the study. Data were tested for normal distribution, and the mean, standard deviation, median, min-max values, and frequencies were used as descriptive statistics. Categorical data were expressed as numbers and percentages (%). The Student’s t-test, one of the parametric tests, was used to compare tumor diameters. Statistical Package for the Social Sciences (SPSS) 23 software (IBM Corp., Chicago, IL, USA) was used for data analysis. A p-value less than 0.05 was considered statistically significant in all tests. Results: The mean age of patients included in the study was 49.55 $\pm$ 11.67 years. Of all patients, 79.5% had a normal delivery. 87 (68%) of the patients were not using any contraceptive method, with 0.7%, condom protection was the least. Among the complaints of patients at admission, postcoital vaginal bleeding was the most common complaint with 42.5%, and asymptomatic patients were the second most common with 22%. Human papillomavirus (HPV) status was unknown in the vast majority of patients (91.3%). Regarding the stage status, stage 1b2 was the most frequently seen stage with 29 patients. Tumor histology revealed SCC in 80.3% and adenocarcinoma in 18.1%. The mean tumor diameter measured by transvaginal ultrasonography (TVS) was 3.30 $\pm$ 1.95, by magnetic resonance imaging (MRI) was 3.37 $\pm$ 2.03, and the pathologically measured tumor diameter was 3.17 $\pm$ 1.86. There was no statistically significant difference between the mean tumor diameter measured by TVS and MRI, MRI and pathology, and TVS and pathology (p: 0.769, p: 0.589, p: 0.891, respectively). Conclusion: When used by specialists experienced in the field of gynecological oncology, ultrasonography can be considered as effective as MRI, especially in tumor size measurement in cervical cancer, due to its ease of use, cheapness, and easy accessibility in regions with low socioeconomic status.

cervical cancer; transvaginal ultrasonography; MRI; postcoital bleeding; tumor diameter

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