Radiomics-based prediction of two-year clinical outcome in locally advanced cervical cancer patients undergoing neoadjuvant chemoradiotherapy

Autorino, Riccardo; Gui, Benedetta; Panza, Giulia; Boldrini, Luca; Cusumano, D.; Russo, Leila; Nardangeli, Alessia; Persiani, Salvatore; Campitelli, M.; Ferrandina, G.; Macchia, G.; Valentini, Vincenzo; Gambacorta, Maria Antonietta; Manfredi, Roberto

doi:10.1007/s11547-022-01482-9

Cited by 32 publications

(22 citation statements)

References 51 publications

(19 reference statements)

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“…Recently, Autorino et al proposed a radiomic model to predict 2 years OS in LACC patients before or during RTCT, and it could be of added clinical value to provide guidance for clinicians in their decision-making process to adapt and tailor treatment [ 46 ]. However, prospective and multicentric larger trials are needed to validate this model and eventually translate it into clinical practice.…”

Section: Discussionmentioning

confidence: 99%

Assessment of Salvage Surgery in Persistent Cervical Cancer after Definitive Radiochemotherapy: A Systematic Review

Conte

Corte²,

Pelligra³

et al. 2023

Medicina

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Background and Objectives: The standard treatment approach in locally advanced cervical cancer (LACC) is exclusive concurrent chemoradiation therapy (RTCT). The risk of local residual disease after six months from RTCT is about 20–30%. It is directly related to relapse risk and poor survival, such as in patients with recurrent cervical cancer. This systematic review aims to describe studies investigating salvage surgery’s role in persistent/recurrent disease in LACC patients who underwent definitive RTCT. Materials and Methods: Studies were eligible for inclusion when patients had LACC with radiologically suspected or histologically confirmed residual disease after definitive RTCT, diagnosed with post-treatment radiological workup or biopsy. Information on complications after salvage surgery and survival outcomes had to be reported. The methodological quality of the articles was independently assessed by two researchers with the Newcastle–Ottawa scale. Following the recommendations in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, we systematically searched the PubMed, Scopus, Cochrane, Medline, and Medscape databases in May 2022. We applied no language or geographical restrictions but considered only English studies. We included studies containing data about postoperative complications and survival outcomes. Results: Eleven studies fulfilled the inclusion criteria and all were retrospective observational studies. A total of 601 patients were analyzed concerning the salvage surgery in LACC patients for persistent/recurrent disease after RTCT treatment. Overall, 369 (61.4%) and 232 (38.6%) patients underwent a salvage hysterectomy (extrafascial or radical) and pelvic exenteration (anterior, posterior, or total), respectively. Four hundred and thirty-nine (73%) patients had histologically confirmed the residual disease in the salvage surgical specimen, and 109 patients had positive margins (overall range 0–43% of the patients). The risk of severe (grade ≥ 3) postoperative complications after salvage surgery is 29.8% (range 5–57.5%). After a median follow-up of 38 months, the overall RR was about 32% with an overall death rate of 40% after hysterectomy or pelvic exenteration with or without lymphadenectomy. Conclusions: There is heterogeneity between the studies both in their design and results, therefore the effect of salvage surgery on survival and recurrence cannot be adequately estimated. Future homogeneous studies with an appropriately selected population are needed to analyze the safety and efficacy of salvage hysterectomy or pelvic exenteration in patients with residual tumors after definitive RTCT.

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Section: Discussionmentioning

confidence: 99%

Assessment of Salvage Surgery in Persistent Cervical Cancer after Definitive Radiochemotherapy: A Systematic Review

Conte

Corte²,

Pelligra³

et al. 2023

Medicina

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“…With such techniques, it is also possible to derive information directly from the images on the molecular and genomic characteristics of the tumor (radiogenomics) with the ultimate intent of extracting indications on aggressiveness, prognosis, and therapeutic response [ 77 , 133 , 201 , 202 , 203 , 204 , 205 , 206 , 207 , 208 , 209 , 210 , 211 , 212 , 213 , 214 , 215 , 216 , 217 , 218 , 219 , 220 , 221 , 222 , 223 , 224 , 225 , 226 , 227 , 228 , 229 , 230 , 231 , 232 ].…”

Section: Precision Medicine: Radiomics and Radiogenomics—the New Fron...mentioning

confidence: 99%

Gender Medicine in Clinical Radiology Practice

Giacobbe

Granata

Trovato

et al. 2023

JPM

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Gender Medicine is rapidly emerging as a branch of medicine that studies how many diseases common to men and women differ in terms of prevention, clinical manifestations, diagnostic-therapeutic approach, prognosis, and psychological and social impact. Nowadays, the presentation and identification of many pathological conditions pose unique diagnostic challenges. However, women have always been paradoxically underestimated in epidemiological studies, drug trials, as well as clinical trials, so many clinical conditions affecting the female population are often underestimated and/or delayed and may result in inadequate clinical management. Knowing and valuing these differences in healthcare, thus taking into account individual variability, will make it possible to ensure that each individual receives the best care through the personalization of therapies, the guarantee of diagnostic-therapeutic pathways declined according to gender, as well as through the promotion of gender-specific prevention initiatives. This article aims to assess potential gender differences in clinical-radiological practice extracted from the literature and their impact on health and healthcare. Indeed, in this context, radiomics and radiogenomics are rapidly emerging as new frontiers of imaging in precision medicine. The development of clinical practice support tools supported by artificial intelligence allows through quantitative analysis to characterize tissues noninvasively with the ultimate goal of extracting directly from images indications of disease aggressiveness, prognosis, and therapeutic response. The integration of quantitative data with gene expression and patient clinical data, with the help of structured reporting as well, will in the near future give rise to decision support models for clinical practice that will hopefully improve diagnostic accuracy and prognostic power as well as ensure a more advanced level of precision medicine.

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“…Several reports have described the role of radiomics as a precision medicine tool [ 102 , 103 ], that could influence therapeutic approaches in RC [ 104 , 105 , 106 , 107 , 108 , 109 , 110 , 111 , 112 , 113 , 114 , 115 ]. Recently, the idea that imaging studies contain a great quantity of data, in the form of grey-level patterns, which are imperceptible to the human eyes, has become more and more interesting [ 116 , 117 , 118 , 119 , 120 , 121 , 122 , 123 , 124 , 125 , 126 , 127 , 128 , 129 , 130 , 131 , 132 , 133 , 134 ].…”

Section: Common Postoperative Complicationsmentioning

confidence: 99%

“…For several tumors, radiomic analyses have already provided an accurate evaluation of biology, allowing the identification of indices correlated with clinical outcomes [ 184 , 185 , 186 , 187 , 188 , 189 , 190 , 191 , 192 ]. Imaging features and texture analysis (TA) built on MR images proved to be able to intercept the therapeutic response to nCRT and tumor recurrence in patients with LARC [ 111 , 112 , 113 , 114 , 115 ]. These preliminary data suggest that it is possible to accurately select patients, building customized, increasingly organ-sparing, diagnostic and therapeutic pathways.…”

Section: Common Postoperative Complicationsmentioning

confidence: 99%

Post-Surgical Imaging Assessment in Rectal Cancer: Normal Findings and Complications

Muzio

Fusco

Cutolo

et al. 2023

JCM

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Rectal cancer (RC) is one of the deadliest malignancies worldwide. Surgery is the most common treatment for RC, performed in 63.2% of patients. The type of surgical approach chosen aims to achieve maximum residual function with the lowest risk of recurrence. The selection is made by a multidisciplinary team that assesses the characteristics of the patient and the tumor. Total mesorectal excision (TME), including both low anterior resection (LAR) and abdominoperineal resection (APR), is still the standard of care for RC. Radical surgery is burdened by a 31% rate of major complications (Clavien–Dindo grade 3–4), such as anastomotic leaks and a risk of a permanent stoma. In recent years, less-invasive techniques, such as local excision, have been tested. These additional procedures could mitigate the morbidity of rectal resection, while providing acceptable oncologic results. The “watch and wait” approach is not a globally accepted model of care but encouraging results on selected groups of patients make it a promising strategy. In this plethora of treatments, the radiologist is called upon to distinguish a physiological from a pathological postoperative finding. The aim of this narrative review is to identify the main post-surgical complications and the most effective imaging techniques.

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Radiomics-based prediction of two-year clinical outcome in locally advanced cervical cancer patients undergoing neoadjuvant chemoradiotherapy

Cited by 32 publications

References 51 publications

Assessment of Salvage Surgery in Persistent Cervical Cancer after Definitive Radiochemotherapy: A Systematic Review

Assessment of Salvage Surgery in Persistent Cervical Cancer after Definitive Radiochemotherapy: A Systematic Review

Gender Medicine in Clinical Radiology Practice

Post-Surgical Imaging Assessment in Rectal Cancer: Normal Findings and Complications

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