{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T11:47:29Z","timestamp":1790596049405,"version":"4.1.0"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,12,8]],"date-time":"2022-12-08T00:00:00Z","timestamp":1670457600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Invisible cervical cancers on MRI can indicate less invasive surgery. Cervical cancers consist of squamous cell carcinoma (SCC) and non-SCC, each with different long-term outcomes. It is still unclear if surgical planning should be changed according to the histologic type of cervical cancer when it is not visible on MRI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Purpose<\/jats:title><jats:p>The purpose of the study was to determine if surgical planning for cervical cancer that is not visible on MRI is influenced by the histologic type.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and methods<\/jats:title><jats:p>Between January 2007 and December 2016, 155 women had Federation of Gynecology and Obstetrics (FIGO) stage 1B1 cervical cancer that was not visible on preoperative MRI. They underwent radical hysterectomies and pelvic lymph node dissections. Among them, 88 and 67 were histologically diagnosed with SCC and non-SCC, respectively. The size of the residual tumor, depth of stromal invasion, parametrial invasion, vaginal invasion, lymphovascular invasion, and lymph node metastasis were compared between these patients using the t-test, Mann\u2013Whitney U test, Chi-squared test, or Fisher\u2019s exact test. The recurrence-free and overall 10-year survival rates were compared between the groups by Kaplan\u2013Meier analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean sizes of residual tumors were 8.4 \u00b1 10.4\u00a0mm in the SCC group and 12.5 \u00b1 11.9\u00a0mm in the non-SCC group (p = 0.024). The mean depth of stromal invasion in the SCC group was 12.4 \u00b1 21.2% (0%\u2013100%), whereas that in the non-SCC group was 22.4 \u00b1 24.4 (0%\u201393%) (p = 0.016). However, there was no difference in parametrial or vaginal invasion, lymphovascular invasion, or lymph node metastasis (p = 0.504\u20131.000). The recurrence-free and overall 10-year survival rates were 98.9% (87\/88) and 95.5% (64\/67) (p = 0.246), and 96.6% (85\/88) and 95.5% (64\/67) (p = 0.872), respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The non-SCC group tends to have larger residual tumors and a greater depth of stromal invasion than the SCC group, even though neither is visible on MRI. Therefore, meticulous care is necessary for performing parametrectomy in patients with non-SCC cervical cancer.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fonc.2022.996516","type":"journal-article","created":{"date-parts":[[2022,12,8]],"date-time":"2022-12-08T13:19:19Z","timestamp":1670505559000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Invisible cervical cancers on MRI: Can the type of histology (SCC versus non-SCC) influence surgical planning?"],"prefix":"10.3389","volume":"12","author":[{"given":"Jungeun","family":"Jeon","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Byung Kwan","family":"Park","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeong-Won","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chel Hun","family":"Choi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoo-Young","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tae-Joong","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Byoungi-Gie","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,12,8]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2014.02.032","article-title":"Postoperative outcomes of MR-invisible stage IB1 cervical cancer","volume":"211","author":"Park","year":"2014","journal-title":"Am J Obstet Gynecol"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.3390\/cancers13164078","article-title":"Useful MRI findings for minimally invasive surgery for early cervical cancer","volume":"13","author":"Park","year":"2021","journal-title":"Cancers (Basel)"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.3390\/cancers14010224","article-title":"Utility of 3T MRI in women with IB1 cervical cancer in determining the necessity of less invasive surgery","volume":"14","author":"Jeong","year":"2022","journal-title":"Cancers (Basel)"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1097\/igc.0000000000000229","article-title":"Magnetic resonance appearance of gastric-type adenocarcinoma of the uterine cervix in comparison with that of usual-type endocervical adenocarcinoma: a pitfall of newly described unusual subtype of endocervical adenocarcinoma","volume":"24","author":"Kido","year":"2014","journal-title":"Int J Gynecol Cancer"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1111\/jog.13083","article-title":"Usefulness of a management protocol for patients with cervical multicystic lesions: A retrospective analysis of 94 cases and the significance of GNAS mutation","volume":"42","author":"Ando","year":"2016","journal-title":"J Obstet Gynaecol Res"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.3348\/kjr.2018.0458","article-title":"Clinical and MRI characteristics of uterine cervical adenocarcinoma: Its variants and mimics","volume":"20","author":"Saida","year":"2019","journal-title":"kjr"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2004.11.018","article-title":"Tailoring the parametrectomy in stages IA2\u2013IB1 cervical carcinoma: is it feasible and safe","volume":"96","author":"Panici","year":"2005","journal-title":"Gynecol Oncol"},{"key":"B8","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1016\/S0090-8258(87)80002-1","article-title":"Radical hysterectomy and pelvic lymphadenectomy for stage IB carcinoma of the cervix: 21 years experience","volume":"28","author":"Artman","year":"1987","journal-title":"Gynecol Oncol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1006\/gyno.2000.6010","article-title":"Class II versus class III radical hysterectomy in stage IB\u2013IIA cervical cancer: A prospective randomized study","volume":"80","author":"Landoni","year":"2001","journal-title":"Gynecol Oncol"},{"key":"B10","doi-asserted-by":"publisher","first-page":"292","DOI":"10.1016\/S1470-2045(09)70191-3","article-title":"Nerve-sparing and individually tailored surgery for cervical cancer","volume":"11","author":"Rob","year":"2010","journal-title":"Lancet Oncol"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2013.10.006","article-title":"Lymphatic and nerve distribution throughout the parametrium","volume":"131","author":"Bonneau","year":"2013","journal-title":"Gynecol Oncol"},{"key":"B12","doi-asserted-by":"publisher","first-page":"181","DOI":"10.3892\/etm.2020.9311","article-title":"Associated risk factors of lower limb lymphedema after treatment of cervical and endometrial cancer","volume":"20","author":"Rebegea","year":"2020","journal-title":"Exp Ther Med"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1093\/jjco\/hyy151","article-title":"Risk factors for lymphatic complications following lymphadenectomy in patients with cervical cancer","volume":"48","author":"Togami","year":"2018","journal-title":"Japanese J Clin Oncol"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1093\/jjco\/hyaa001","article-title":"Comparison of lymphatic complications between sentinel node navigation surgery and pelvic lymphadenectomy in patients with cervical cancer","volume":"50","author":"Togami","year":"2020","journal-title":"Japanese J Clin Oncol"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2009.02.012","article-title":"Revised FIGO staging for carcinoma of the vulva, cervix, and endometrium","volume":"105","author":"Pecorelli","year":"2009","journal-title":"Int J Gynaecol Obstet"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2006.01.027","article-title":"Early cervical cancer and parametrial involvement: Is it significant","volume":"103","author":"Steed","year":"2006","journal-title":"Gynecol Oncol"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.3802\/jgo.2015.26.4.255","article-title":"Pretreatment risk factors for parametrial involvement in FIGO stage IB1 cervical cancer","volume":"26","author":"Yamazaki","year":"2015","journal-title":"J Gynecol Oncol"},{"key":"B18","doi-asserted-by":"publisher","first-page":"349","DOI":"10.1097\/IGC.0b013e3182072eea","article-title":"Parametrial involvement in FIGO stage IB1 cervical carcinoma: Diagnostic impact of tumor diameter in preoperative magnetic resonance imaging","volume":"21","author":"Kamimori","year":"2011","journal-title":"Int J Gynecol Cancer"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2005.10.012","article-title":"Can MRI rule out bladder and rectal invasion in cervical cancer to help select patients for limited EUA","volume":"101","author":"Rockall","year":"2006","journal-title":"Gynecol Oncol"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2009.02.009","article-title":"Revised FIGO staging for carcinoma of the cervix","volume":"105","author":"Pecorelli","year":"2009","journal-title":"Int J Gynaecol Obstet"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.3802\/jgo.2012.23.2.80","article-title":"Indications for endoscopy according to the revised FIGO staging for cervical cancer after MRI and CT scanning","volume":"23","author":"Jeong","year":"2012","journal-title":"J Gynecol Oncol"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1055\/a-1198-5729","article-title":"Revised FIGO staging for cervical cancer - a new role for MRI","volume":"192","author":"Merz","year":"2020","journal-title":"Rofo"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.190.3.8115631","article-title":"Uterine cervical carcinoma: evaluation of pelvic lymph node metastasis with MR imaging","volume":"190","author":"Kim","year":"1994","journal-title":"Radiology"},{"key":"B24","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1016\/s0090-8258(03)00409-8","article-title":"Computed tomography and magnetic resonance imaging in staging of uterine cervical carcinoma: a systematic review","volume":"91","author":"Bipat","year":"2003","journal-title":"Gynecol Oncol"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1259\/bjr.20150063","article-title":"Diagnostic performance of diffusion-weighted MRI for detection of pelvic metastatic lymph nodes in patients with cervical cancer: a systematic review and meta-analysis","volume":"88","author":"Shen","year":"2015","journal-title":"Br J Radiol"},{"key":"B26","doi-asserted-by":"publisher","first-page":"77","DOI":"10.4103\/0973-1482.148726","article-title":"Diagnostic value of lymph node metastasis by diffusion-weighted magnetic resonance imaging in cervical cancer","volume":"12","author":"He","year":"2016","journal-title":"J Cancer Res Ther"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1016\/j.crad.2018.10.013","article-title":"Making the invisible visible: improving detectability of MRI-invisible residual cervical cancer after conisation by DCE-MRI","volume":"74","author":"Huang","year":"2019","journal-title":"Clin Radiol"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1259\/bjr.20210986","article-title":"Added value of radiomics analysis in MRI invisible early-stage cervical cancers","volume":"95","author":"Hu","year":"2022","journal-title":"Br J Radiol"},{"key":"B29","doi-asserted-by":"publisher","first-page":"2446","DOI":"10.3390\/diagnostics12102446","article-title":"Radiomics based on nomogram predict pelvic lymphnode metastasis in early-stage cervical cancer","volume":"12","author":"Xia","year":"2022","journal-title":"Diagnostics"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1148\/rg.2020200013","article-title":"2018 FIGO staging classification for cervical cancer: Added benefits of imaging","volume":"40","author":"Salib","year":"2020","journal-title":"Radiographics"}],"container-title":["Frontiers in Oncology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2022.996516\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,12,8]],"date-time":"2022-12-08T13:19:22Z","timestamp":1670505562000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2022.996516\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,8]]},"references-count":30,"alternative-id":["10.3389\/fonc.2022.996516"],"URL":"https:\/\/doi.org\/10.3389\/fonc.2022.996516","relation":{},"ISSN":["2234-943X"],"issn-type":[{"value":"2234-943X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,12,8]]},"article-number":"996516"}}