Frequency and risk factors of thoracic metastases and optimisation of the use of cross-sectional chest imaging in follow-up patients with cervical cancer
To optimise cross-sectional chest imaging usage by identifying frequency and risk factors associated with thoracic metastases in cervical cancer patients after initial definitive treatment. This study, conducted during 2004–2015, examined 361 consecutive patients with histopathologically proven cerv...
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| Veröffentlicht in: | Clinical radiology 2019-04, Vol.74 (4), p.326.e1-326.e8 |
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| creator | Nakao, K.K. Kido, A. Imai, T. Abiko, K. Fujimoto, K. Horie, A. Minamiguchi, S. Tanaka, S. Mandai, M. Togashi, K. |
| description | To optimise cross-sectional chest imaging usage by identifying frequency and risk factors associated with thoracic metastases in cervical cancer patients after initial definitive treatment.
This study, conducted during 2004–2015, examined 361 consecutive patients with histopathologically proven cervical carcinoma with at least 1 year of follow-up. Electronic medical records and all available imaging modes were used to record and assess patient and tumour characteristics and timing of thoracic metastases. Associations with these characteristics and thoracic metastases were assessed using univariate and multivariable Cox proportional hazards modelling.
Of the 361 patients, 31 developed thoracic metastases. Multivariate regression results showed that adeno/adenosquamous carcinomas (hazard ratio [HR], 2.46; 95% confidence interval [CI], 1.06 to 5.72), other histology (HR, 5.61; 95% CI, 1.81 to 17.42), high International Federation of Gynaecology and Obstetrics (FIGO) stage (HR, 2.84; 95% CI, 1.09 to 7.37), and presence of initial intra-abdominal lymph node metastases (HR, 2.46; 95% CI, 1.02 to 5.90) were associated significantly and independently with thoracic metastases. The second analysis among the subgroup of surgical treatment identified intermediate–high risk classification of recurrence (HR, 5.12; 95% CI, 1.14 to 22.94), high FIGO stage (HR, 2.73; 95% CI, 1.05 to 7.13), and other histology (HR, 11.51; 95% CI, 3.66 to 36.19) as independent predictors of thoracic metastases. Two of the 361 and 2/313 patients with thoracic metastases who did not correspond to the conditions above were in the respective evaluation groups.
Assessment of negative prognostic factors for thoracic metastases might contribute to reduced need for chest cross-sectional chest computed tomography examinations.
•Non-SCC histology was one of the negative prognostic factors for thoracic metastases.•High FIGO stage and initial lymph node metastases were negative prognosis factors.•Appropriate usage of chest CT imaging may reduce radiation exposure for patients. |
| doi_str_mv | 10.1016/j.crad.2018.11.014 |
| format | Article |
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This study, conducted during 2004–2015, examined 361 consecutive patients with histopathologically proven cervical carcinoma with at least 1 year of follow-up. Electronic medical records and all available imaging modes were used to record and assess patient and tumour characteristics and timing of thoracic metastases. Associations with these characteristics and thoracic metastases were assessed using univariate and multivariable Cox proportional hazards modelling.
Of the 361 patients, 31 developed thoracic metastases. Multivariate regression results showed that adeno/adenosquamous carcinomas (hazard ratio [HR], 2.46; 95% confidence interval [CI], 1.06 to 5.72), other histology (HR, 5.61; 95% CI, 1.81 to 17.42), high International Federation of Gynaecology and Obstetrics (FIGO) stage (HR, 2.84; 95% CI, 1.09 to 7.37), and presence of initial intra-abdominal lymph node metastases (HR, 2.46; 95% CI, 1.02 to 5.90) were associated significantly and independently with thoracic metastases. The second analysis among the subgroup of surgical treatment identified intermediate–high risk classification of recurrence (HR, 5.12; 95% CI, 1.14 to 22.94), high FIGO stage (HR, 2.73; 95% CI, 1.05 to 7.13), and other histology (HR, 11.51; 95% CI, 3.66 to 36.19) as independent predictors of thoracic metastases. Two of the 361 and 2/313 patients with thoracic metastases who did not correspond to the conditions above were in the respective evaluation groups.
Assessment of negative prognostic factors for thoracic metastases might contribute to reduced need for chest cross-sectional chest computed tomography examinations.
•Non-SCC histology was one of the negative prognostic factors for thoracic metastases.•High FIGO stage and initial lymph node metastases were negative prognosis factors.•Appropriate usage of chest CT imaging may reduce radiation exposure for patients.</description><identifier>ISSN: 0009-9260</identifier><identifier>EISSN: 1365-229X</identifier><identifier>DOI: 10.1016/j.crad.2018.11.014</identifier><identifier>PMID: 30771995</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Diagnostic Imaging - methods ; Female ; Humans ; Lymphatic Metastasis - diagnostic imaging ; Middle Aged ; Risk Factors ; Thoracic Neoplasms - diagnostic imaging ; Thoracic Neoplasms - secondary ; Uterine Cervical Neoplasms - pathology</subject><ispartof>Clinical radiology, 2019-04, Vol.74 (4), p.326.e1-326.e8</ispartof><rights>2019 The Royal College of Radiologists</rights><rights>Copyright © 2019 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c307t-398c2e95be9d681a907d1e2d169eb086e4d047f3e036defcc5ddd8705d200bf23</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.crad.2018.11.014$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30771995$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Nakao, K.K.</creatorcontrib><creatorcontrib>Kido, A.</creatorcontrib><creatorcontrib>Imai, T.</creatorcontrib><creatorcontrib>Abiko, K.</creatorcontrib><creatorcontrib>Fujimoto, K.</creatorcontrib><creatorcontrib>Horie, A.</creatorcontrib><creatorcontrib>Minamiguchi, S.</creatorcontrib><creatorcontrib>Tanaka, S.</creatorcontrib><creatorcontrib>Mandai, M.</creatorcontrib><creatorcontrib>Togashi, K.</creatorcontrib><title>Frequency and risk factors of thoracic metastases and optimisation of the use of cross-sectional chest imaging in follow-up patients with cervical cancer</title><title>Clinical radiology</title><addtitle>Clin Radiol</addtitle><description>To optimise cross-sectional chest imaging usage by identifying frequency and risk factors associated with thoracic metastases in cervical cancer patients after initial definitive treatment.
This study, conducted during 2004–2015, examined 361 consecutive patients with histopathologically proven cervical carcinoma with at least 1 year of follow-up. Electronic medical records and all available imaging modes were used to record and assess patient and tumour characteristics and timing of thoracic metastases. Associations with these characteristics and thoracic metastases were assessed using univariate and multivariable Cox proportional hazards modelling.
Of the 361 patients, 31 developed thoracic metastases. Multivariate regression results showed that adeno/adenosquamous carcinomas (hazard ratio [HR], 2.46; 95% confidence interval [CI], 1.06 to 5.72), other histology (HR, 5.61; 95% CI, 1.81 to 17.42), high International Federation of Gynaecology and Obstetrics (FIGO) stage (HR, 2.84; 95% CI, 1.09 to 7.37), and presence of initial intra-abdominal lymph node metastases (HR, 2.46; 95% CI, 1.02 to 5.90) were associated significantly and independently with thoracic metastases. The second analysis among the subgroup of surgical treatment identified intermediate–high risk classification of recurrence (HR, 5.12; 95% CI, 1.14 to 22.94), high FIGO stage (HR, 2.73; 95% CI, 1.05 to 7.13), and other histology (HR, 11.51; 95% CI, 3.66 to 36.19) as independent predictors of thoracic metastases. Two of the 361 and 2/313 patients with thoracic metastases who did not correspond to the conditions above were in the respective evaluation groups.
Assessment of negative prognostic factors for thoracic metastases might contribute to reduced need for chest cross-sectional chest computed tomography examinations.
•Non-SCC histology was one of the negative prognostic factors for thoracic metastases.•High FIGO stage and initial lymph node metastases were negative prognosis factors.•Appropriate usage of chest CT imaging may reduce radiation exposure for patients.</description><subject>Diagnostic Imaging - methods</subject><subject>Female</subject><subject>Humans</subject><subject>Lymphatic Metastasis - diagnostic imaging</subject><subject>Middle Aged</subject><subject>Risk Factors</subject><subject>Thoracic Neoplasms - diagnostic imaging</subject><subject>Thoracic Neoplasms - secondary</subject><subject>Uterine Cervical Neoplasms - pathology</subject><issn>0009-9260</issn><issn>1365-229X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU9rFTEUxYMo9rX1C7iQLN3MeG_mb8CNFKuFQjcK3YW85E5fnvMmY5Jp6Ufx25rpqy4LgdyQ3zlw7mHsPUKJgO2nfWmCtqUA7EvEErB-xTZYtU0hhLx9zTYAIAspWjhhpzHu12ct6rfspIKuQymbDftzGej3QpN55HqyPLj4iw_aJB8i9wNPOx-0cYYfKOmYD8Unzs_JHVzUyfnpyBFfIq2jCT7GIpJZ__TIzY5i4u6g79x0x93EBz-O_qFYZj5nPU0p8geXdtxQuHdmVegpz-fszaDHSO-e7zP28_Lrj4vvxfXNt6uLL9eFySlSUcneCJLNlqRte9QSOoskLLaSttC3VFuou6EiqFpLgzGNtbbvoLECYDuI6ox9PPrOwedNxKRyMEPjqCfyS1QC-wr7XuCKiiP6lDHQoOaQg4VHhaDWStRerZWotRKFqHIlWfTh2X_ZHsj-l_zrIAOfjwDllPeOgoomr8WQdSFvUVnvXvL_C_m_oM4</recordid><startdate>201904</startdate><enddate>201904</enddate><creator>Nakao, K.K.</creator><creator>Kido, A.</creator><creator>Imai, T.</creator><creator>Abiko, K.</creator><creator>Fujimoto, K.</creator><creator>Horie, A.</creator><creator>Minamiguchi, S.</creator><creator>Tanaka, S.</creator><creator>Mandai, M.</creator><creator>Togashi, K.</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201904</creationdate><title>Frequency and risk factors of thoracic metastases and optimisation of the use of cross-sectional chest imaging in follow-up patients with cervical cancer</title><author>Nakao, K.K. ; Kido, A. ; Imai, T. ; Abiko, K. ; Fujimoto, K. ; Horie, A. ; Minamiguchi, S. ; Tanaka, S. ; Mandai, M. ; Togashi, K.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c307t-398c2e95be9d681a907d1e2d169eb086e4d047f3e036defcc5ddd8705d200bf23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Diagnostic Imaging - methods</topic><topic>Female</topic><topic>Humans</topic><topic>Lymphatic Metastasis - diagnostic imaging</topic><topic>Middle Aged</topic><topic>Risk Factors</topic><topic>Thoracic Neoplasms - diagnostic imaging</topic><topic>Thoracic Neoplasms - secondary</topic><topic>Uterine Cervical Neoplasms - pathology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Nakao, K.K.</creatorcontrib><creatorcontrib>Kido, A.</creatorcontrib><creatorcontrib>Imai, T.</creatorcontrib><creatorcontrib>Abiko, K.</creatorcontrib><creatorcontrib>Fujimoto, K.</creatorcontrib><creatorcontrib>Horie, A.</creatorcontrib><creatorcontrib>Minamiguchi, S.</creatorcontrib><creatorcontrib>Tanaka, S.</creatorcontrib><creatorcontrib>Mandai, M.</creatorcontrib><creatorcontrib>Togashi, K.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical radiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Nakao, K.K.</au><au>Kido, A.</au><au>Imai, T.</au><au>Abiko, K.</au><au>Fujimoto, K.</au><au>Horie, A.</au><au>Minamiguchi, S.</au><au>Tanaka, S.</au><au>Mandai, M.</au><au>Togashi, K.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Frequency and risk factors of thoracic metastases and optimisation of the use of cross-sectional chest imaging in follow-up patients with cervical cancer</atitle><jtitle>Clinical radiology</jtitle><addtitle>Clin Radiol</addtitle><date>2019-04</date><risdate>2019</risdate><volume>74</volume><issue>4</issue><spage>326.e1</spage><epage>326.e8</epage><pages>326.e1-326.e8</pages><issn>0009-9260</issn><eissn>1365-229X</eissn><abstract>To optimise cross-sectional chest imaging usage by identifying frequency and risk factors associated with thoracic metastases in cervical cancer patients after initial definitive treatment.
This study, conducted during 2004–2015, examined 361 consecutive patients with histopathologically proven cervical carcinoma with at least 1 year of follow-up. Electronic medical records and all available imaging modes were used to record and assess patient and tumour characteristics and timing of thoracic metastases. Associations with these characteristics and thoracic metastases were assessed using univariate and multivariable Cox proportional hazards modelling.
Of the 361 patients, 31 developed thoracic metastases. Multivariate regression results showed that adeno/adenosquamous carcinomas (hazard ratio [HR], 2.46; 95% confidence interval [CI], 1.06 to 5.72), other histology (HR, 5.61; 95% CI, 1.81 to 17.42), high International Federation of Gynaecology and Obstetrics (FIGO) stage (HR, 2.84; 95% CI, 1.09 to 7.37), and presence of initial intra-abdominal lymph node metastases (HR, 2.46; 95% CI, 1.02 to 5.90) were associated significantly and independently with thoracic metastases. The second analysis among the subgroup of surgical treatment identified intermediate–high risk classification of recurrence (HR, 5.12; 95% CI, 1.14 to 22.94), high FIGO stage (HR, 2.73; 95% CI, 1.05 to 7.13), and other histology (HR, 11.51; 95% CI, 3.66 to 36.19) as independent predictors of thoracic metastases. Two of the 361 and 2/313 patients with thoracic metastases who did not correspond to the conditions above were in the respective evaluation groups.
Assessment of negative prognostic factors for thoracic metastases might contribute to reduced need for chest cross-sectional chest computed tomography examinations.
•Non-SCC histology was one of the negative prognostic factors for thoracic metastases.•High FIGO stage and initial lymph node metastases were negative prognosis factors.•Appropriate usage of chest CT imaging may reduce radiation exposure for patients.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>30771995</pmid><doi>10.1016/j.crad.2018.11.014</doi></addata></record> |
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| subjects | Diagnostic Imaging - methods Female Humans Lymphatic Metastasis - diagnostic imaging Middle Aged Risk Factors Thoracic Neoplasms - diagnostic imaging Thoracic Neoplasms - secondary Uterine Cervical Neoplasms - pathology |
| title | Frequency and risk factors of thoracic metastases and optimisation of the use of cross-sectional chest imaging in follow-up patients with cervical cancer |
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