Radiomic models for lymph node metastasis prediction in cervical cancer: can we think beyond sentinel lymph node?

Abstract

Liu and colleagues performed a retrospective study to validate a computed tomography (CT) scan-based radiomic model to detect lymph node metastasis in cervical cancer. The proposed model incorporating the arterial and venous phase CT-scan features represented a non-invasive method exhibiting high sensitivity in the prediction of lymph node metastasis. It is well established that lymph node metastasis is one of the most significant prognostic factors in cervical cancer. For this reason, management of cervical cancer is strictly related to lymph node status, with international guidelines recommending definitive chemo-radiation in case of metastatic lymph node. More and more evidence supports the use of sentinel lymph node in early-stage cervical cancer but its frozen section analysis may result in false negative results; in locally-advanced stages staging para-aortic lymphadenectomy is proposed by many Authors to tailor chemoradiotherapy treatment, with potential intra-and post-operative related complications. The use of a validated radiomic model able to predict lymph node metastases in radiologically normal lymph nodes may represent an essential tool to possibly spare lympadenectomy related morbidity.

Treatment planning computed tomography radiomics for predicting treatment outcomes and haematological toxicities in locally advanced cervical cancer treated with radiotherapy: A retrospective cohort study

“…Previous studies have demonstrated that tumour volume, pelvic lymph node status 36 and concurrent chemotherapy are independent prognostic factors of LACC 3 . But Lucia et al 37 reported that radiomic models have higher prognostic power than clinicopathological parameters, such as FIGO stage, tumour volume and nodal stage.…”

Prediction of lymph node metastasis in operable cervical cancer using clinical parameters and deep learning with MRI data: a multicentre study

“…LNM is one of the main causes of poor prognosis in patients with cervical cancer [ 34 , 35 ]. In the early, middle, and advanced stages, the 5-year survival rate of cervical cancer without lymph node metastasis is close to 90%, while the 5-year survival rate drops sharply to 65% in cervical cancer with lymph node metastasis [ 34 ].…”

Editorial: Lymph node assessment in cervical cancer

“…Recently, the potential application of a radiomics model to predict the risk of cervical cancer has been proposed with very interesting results (18,19). The combination of radiomics with clinicopathologic markers may aid in predicting the risk of lymph node metastasis with high accuracy.…”