A RECENT study presented at the 2025 European Society of Gynaecological Oncology (ESGO) Annual Meeting has highlighted the accuracy of preoperative tumour size assessment in patients with FIGO 2018 stage IB2 cervical cancer. The research, led by Teresa Lucia Pan and colleagues, aimed to compare preoperative tumour size evaluations with final pathology results and examine the frequency of adjuvant treatment in patients whose tumour size was ≥3cm.
The study analysed data from 675 patients across three databases: the MD Anderson Cancer Centre (n=75), the SUCCOR Study Group (n=350), and the Multi-institutional Database LATAM (n=250). The median age of participants was 46 years (range; 22-82), with the majority having squamous carcinoma (68%, n=456) and high-grade disease (84%, n=564). Preoperative imaging techniques, including MRI, ultrasound, and CT scans, were used to assess tumour size.
The results revealed that preoperative assessments, including physical exams, MRI, ultrasound, and CT scans, generally overestimated tumour size. However, only the biases found in physical exams (p<0.0001) and MRI (p=0.0102) were statistically significant. Notably, for patients who had a preoperative MRI, 83.2% with tumour sizes of 2-4 cm showed concordance with final pathology measurements.
Of the 340 (50%) patients with tumours measuring 3cm or larger on pathology, 61% received adjuvant therapy. The study also found that the incidence of positive lymph nodes increased with tumour size on pathology (2-2.99 cm; 13% (29/222) vs. 3-4 cm; 21% (66/316), p=0.022). In conclusion, the study underscores the importance of accurate preoperative tumour size assessment in FIGO 2018 stage IB2 cervical cancer, revealing overestimations in imaging techniques but highlighting the role of tumour size in guiding adjuvant therapy decisions.
Helena Bradbury, EMJ
Reference
Pan TL et al. PSA-002: Accuracy of preoperative tumor size assessment compared to final pathology and frequency of adjuvant treatment in patients with FIGO 2018 stage IB2 cervical cancer. Presented at ESGO 2025 Annual Meeting; Feb 20-23; Milan, Italy.
