{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T03:42:53Z","timestamp":1790394173682,"version":"4.1.0"},"reference-count":25,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,6,23]],"date-time":"2023-06-23T00:00:00Z","timestamp":1687478400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate the prognostic value of tumor volume on preoperative MRI in endometrial cancer (EC) patients and its association with adverse prognostic factors and survival.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective observational study with 127 consecutive patients with endometrioid EC was carried out between 2016 and 2021 at Juan Ram\u00f3n Jim\u00e9nez University Hospital, Huelva (Spain). All patients underwent preoperative magnetic resonance imaging (MRI) for local staging. The tumor volume was analyzed on MRI by two different methods: by measuring the three maximum diameters of the tumor according to an ellipse formula and by manual region of interest in different sections; the ratio between tumor volume and uterus volume was also calculated as a third tool. The relationships between volume, prognostic factors, and survival were analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 127 patients with endometroid EC underwent preoperative MRI and were included in the study. Tumor volume was significantly higher for deep myometrial invasion, cervical stromal involvement, infiltrated serosa, lymph node metastases, high\u2010grade EC, and lymphovascular space involvement, advanced FIGO stage, and High Recurrence Risk Group (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). ROC curves showed that tumor volume greater than 25\u2009cm<jats:sup>3<\/jats:sup> predicts lymph node metastases. Volume index greater than 17\u2009cm<jats:sup>3<\/jats:sup> was associated with reduced disease\u2010free survival (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) and overall survival (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.003). Multivariate analysis showed that the greatest tumor volume had an independent impact on recurrence (odds ratio [OR]1.019, 95% confidence interval [CI] 1.005\u20131.032) and survival (OR 1.027, 95% CI 1.009\u20131.046).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study shows an important correlation between tumor volume on MRI and poor prognostic factors. Preoperative tumor volume on MRI is a valuable biomarker to be considered for management of EC.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ijgo.14954","type":"journal-article","created":{"date-parts":[[2023,6,25]],"date-time":"2023-06-25T00:29:22Z","timestamp":1687652962000},"page":"840-846","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Role of tumor volume in endometrial cancer: An imaging analysis and prognosis significance"],"prefix":"10.1002","volume":"163","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2155-4005","authenticated-orcid":false,"given":"Elga","family":"L\u00f3pez\u2010Gonz\u00e1lez","sequence":"first","affiliation":[{"name":"Gynecological Oncology Unit, Department of Obstetrics and Gynecology Hospital Universitario Juan Ram\u00f3n Jim\u00e9nez  Huelva Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Rodriguez\u2010Jim\u00e9nez","sequence":"additional","affiliation":[{"name":"Department of Radiology Hospital Universitario Juan Ram\u00f3n Jim\u00e9nez  Huelva Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan","family":"G\u00f3mez\u2010Salgado","sequence":"additional","affiliation":[{"name":"Department of Sociology, Social Work and Public Health, Faculty of Labor Sciences University of Huelva  Huelva Spain"},{"name":"Safety and Health Postgraduate Programme Universidad Esp\u00edritu Santo  Guayaquil Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cinta","family":"Daza\u2010Manzano","sequence":"additional","affiliation":[{"name":"Gynecological Oncology Unit, Department of Obstetrics and Gynecology Hospital Universitario Juan Ram\u00f3n Jim\u00e9nez  Huelva Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Antonio","family":"Rojas\u2010Luna","sequence":"additional","affiliation":[{"name":"Gynecological Oncology Unit, Department of Obstetrics and Gynecology Hospital Universitario Juan Ram\u00f3n Jim\u00e9nez  Huelva Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosa Mar\u00eda","family":"Alvarez","sequence":"additional","affiliation":[{"name":"Gynecological Oncology and Breast Cancer Unit, Department of Obstetrics and Gynecology Hospital Universitario Santa Cristina  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,6,23]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21590"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21660"},{"key":"e_1_2_8_4_1","volume-title":"WHO Classification of Female Genital Tumours: WHO Classification of Tumours","author":"International Agency for Research on Cancer, World Health Organization","year":"2020"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2009.02.012"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.12120315"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2019.01007"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/jmri.27142"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/jmri.27444"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-015-4583-3"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1148\/rg.282075068"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lungcan.2016.12.013"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000014963"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/jmri.24351"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1593\/tlo.13877"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2014.02.003"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.2307\/2529310"},{"key":"e_1_2_8_18_1","volume-title":"Illustrated Guide to the TNM\/pTNM Classification of Malignant Tumours","author":"TNM Atlas","year":"2004"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2008.10.026"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-10-0125"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.crad.2014.03.020"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2013.02.034"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-011-2220-5"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/IGC.0000000000000367"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.2478\/raon-2020-0064"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1136\/ijgc-2018-000044"}],"container-title":["International Journal of Gynecology &amp; 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