Tumor Invasion Distance Based on MRI Is a Novel Prognostic Indicator for I-IIIB Cervical Cancer Patients Treated with Radiotherapy

<b>Aims:</b>This study aimed to identify the prognostic value of tumor invasion distance (TID) based on MRI findings in cervical-cancer (CC) patients treated with radiotherapy (RT). <b>Methods</b>: A total of 218 CC patients diagnosed at Fujian Cancer Hospital from December 2...

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Main Authors: Linying Liu, Jie Lin, Anyang Li, Ning Xie, Jianfeng Zheng, Youping Xiao, Xuefen Lin, Shizhong Wu, Haijuan Yu, Yang Sun
Format: Article
Language:English
Published: MDPI AG 2025-06-01
Series:Current Oncology
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Online Access:https://www.mdpi.com/1718-7729/32/6/355
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author Linying Liu
Jie Lin
Anyang Li
Ning Xie
Jianfeng Zheng
Youping Xiao
Xuefen Lin
Shizhong Wu
Haijuan Yu
Yang Sun
author_facet Linying Liu
Jie Lin
Anyang Li
Ning Xie
Jianfeng Zheng
Youping Xiao
Xuefen Lin
Shizhong Wu
Haijuan Yu
Yang Sun
author_sort Linying Liu
collection DOAJ
description <b>Aims:</b>This study aimed to identify the prognostic value of tumor invasion distance (TID) based on MRI findings in cervical-cancer (CC) patients treated with radiotherapy (RT). <b>Methods</b>: A total of 218 CC patients diagnosed at Fujian Cancer Hospital from December 2018 to December 2019 were included in the study. Cox regression analyses were conducted to identify independent prognostic factors for overall survival (OS), including low 1/3 vaginal involvement, a longer TID, and RT without chemotherapy. These factors were subsequently used to construct a nomogram for individualized risk prediction. Kaplan–Meier survival analysis was employed to evaluate survival outcomes and establish a risk stratification system. The performance of the new stratification was assessed using the linear trend χ<sup>2</sup> test, Akaike information criterion, and Harrell’s concordance index. <b>Results</b>: A longer TID was associated with worse 3-year OS (<i>p</i> < 0.001, HR: 3.42, 95% CI: 1.67–7.00). A longer TID, lower 1/3 vaginal involvement, and concurrent chemotherapy were independent prognostic survival factors for CC patients. Compared with the 2018 FIGO staging system, the new risk stratification system provided better monotonicity with a higher linear trend χ<sup>2</sup> value (28.03 vs. 9.35), better discriminatory ability with smaller Akaike information criterion (312 vs. 331), and a greater Harrell C statistic (0.74 vs. 0.65) for predicting 3-year OS. <b>Conclusions</b>: This was the first study to demonstrate the prognostic value of TID in CC patients who received RT. The new risk stratification system based on TID could complement the 2018 FIGO staging system in identifying high-risk patients for more intense treatment and care. Further prospective research with larger samples is warranted to confirm the significance of TID for CC patients treated with RT.
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spelling doaj-art-432f47b002ba4ae7a6f376f72f42e1632025-08-20T03:27:06ZengMDPI AGCurrent Oncology1198-00521718-77292025-06-0132635510.3390/curroncol32060355Tumor Invasion Distance Based on MRI Is a Novel Prognostic Indicator for I-IIIB Cervical Cancer Patients Treated with RadiotherapyLinying Liu0Jie Lin1Anyang Li2Ning Xie3Jianfeng Zheng4Youping Xiao5Xuefen Lin6Shizhong Wu7Haijuan Yu8Yang Sun9Department of Gynecology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuma Road, Fuzhou 350014, ChinaDepartment of Gynecology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuma Road, Fuzhou 350014, ChinaDepartment of Gynecology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuma Road, Fuzhou 350014, ChinaDepartment of Gynecology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuma Road, Fuzhou 350014, ChinaDepartment of Gynecology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuma Road, Fuzhou 350014, ChinaDepartment of Radiology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou 350014, ChinaDepartment of Gynecology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuma Road, Fuzhou 350014, ChinaDepartment of Radiology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou 350014, ChinaDepartment of Gynecology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuma Road, Fuzhou 350014, ChinaDepartment of Gynecology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuma Road, Fuzhou 350014, China<b>Aims:</b>This study aimed to identify the prognostic value of tumor invasion distance (TID) based on MRI findings in cervical-cancer (CC) patients treated with radiotherapy (RT). <b>Methods</b>: A total of 218 CC patients diagnosed at Fujian Cancer Hospital from December 2018 to December 2019 were included in the study. Cox regression analyses were conducted to identify independent prognostic factors for overall survival (OS), including low 1/3 vaginal involvement, a longer TID, and RT without chemotherapy. These factors were subsequently used to construct a nomogram for individualized risk prediction. Kaplan–Meier survival analysis was employed to evaluate survival outcomes and establish a risk stratification system. The performance of the new stratification was assessed using the linear trend χ<sup>2</sup> test, Akaike information criterion, and Harrell’s concordance index. <b>Results</b>: A longer TID was associated with worse 3-year OS (<i>p</i> < 0.001, HR: 3.42, 95% CI: 1.67–7.00). A longer TID, lower 1/3 vaginal involvement, and concurrent chemotherapy were independent prognostic survival factors for CC patients. Compared with the 2018 FIGO staging system, the new risk stratification system provided better monotonicity with a higher linear trend χ<sup>2</sup> value (28.03 vs. 9.35), better discriminatory ability with smaller Akaike information criterion (312 vs. 331), and a greater Harrell C statistic (0.74 vs. 0.65) for predicting 3-year OS. <b>Conclusions</b>: This was the first study to demonstrate the prognostic value of TID in CC patients who received RT. The new risk stratification system based on TID could complement the 2018 FIGO staging system in identifying high-risk patients for more intense treatment and care. Further prospective research with larger samples is warranted to confirm the significance of TID for CC patients treated with RT.https://www.mdpi.com/1718-7729/32/6/355cervical cancerradiotherapytumor invasion distanceMRIprognosis
spellingShingle Linying Liu
Jie Lin
Anyang Li
Ning Xie
Jianfeng Zheng
Youping Xiao
Xuefen Lin
Shizhong Wu
Haijuan Yu
Yang Sun
Tumor Invasion Distance Based on MRI Is a Novel Prognostic Indicator for I-IIIB Cervical Cancer Patients Treated with Radiotherapy
Current Oncology
cervical cancer
radiotherapy
tumor invasion distance
MRI
prognosis
title Tumor Invasion Distance Based on MRI Is a Novel Prognostic Indicator for I-IIIB Cervical Cancer Patients Treated with Radiotherapy
title_full Tumor Invasion Distance Based on MRI Is a Novel Prognostic Indicator for I-IIIB Cervical Cancer Patients Treated with Radiotherapy
title_fullStr Tumor Invasion Distance Based on MRI Is a Novel Prognostic Indicator for I-IIIB Cervical Cancer Patients Treated with Radiotherapy
title_full_unstemmed Tumor Invasion Distance Based on MRI Is a Novel Prognostic Indicator for I-IIIB Cervical Cancer Patients Treated with Radiotherapy
title_short Tumor Invasion Distance Based on MRI Is a Novel Prognostic Indicator for I-IIIB Cervical Cancer Patients Treated with Radiotherapy
title_sort tumor invasion distance based on mri is a novel prognostic indicator for i iiib cervical cancer patients treated with radiotherapy
topic cervical cancer
radiotherapy
tumor invasion distance
MRI
prognosis
url https://www.mdpi.com/1718-7729/32/6/355
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