Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
3
pubmed:dateCreated
2006-6-28
pubmed:abstractText
Inguinofemoral lymphadenectomy contributes to the high morbidity related to surgical treatment of vulval cancer. The objective of this study was to assess the accuracy of magnetic resonance imaging (MRI) in predicting inguinofemoral lymph nodes metastasis in women with vulval cancer. We reviewed the clinical, MRI, surgical, and pathologic findings of 59 women with vulval cancer who were treated at our institution from January 2000 to June 2004. Histology was available for 39 women who had undergone inguinofemoral lymphadenectomy. Clinical and MRI findings were compared with histology result to assess test accuracy. MRI had a positive likelihood ratio (LR+) of 4.8 (95% confidence interval of 2.7-8.6) and negative likelihood ratio (LR-) of 0.17 (0.06-0.49). It had a sensitivity of 85.7% (63.7-97), specificity of 82.1% (69.6-91.1), positive predictive value (PPV) of 64.3% (44.1-81.4), and negative predictive value (NPV) of 93.9% (83.1-98.7). Clinical examination had an LR+ of 6.1 (1.8-21.6) and LR- of 0.69 (0.5-0.96). It had a sensitivity of 35% (15.3-59.4), specificity of 94.3% (84.3-98.8), PPV of 70% (34.7-93.3), and NPV of 79.4% (67.3-88.5). Kappa statistics for interobserver and intraobserver agreement were 0.9091 and 0.8475, respectively. MRI assessment was accurate in predicting negative nodal status that is clinically useful in identifying women who can be spared inguinofemoral lymphadenectomy. It is noninvasive and is superior to clinical assessment. In clinical practice, this should encourage toward nodal sparing surgery, thus lowering surgical-related patient morbidity.
pubmed:commentsCorrections
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:status
MEDLINE
pubmed:issn
1048-891X
pubmed:author
pubmed:issnType
Print
pubmed:volume
16
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
1179-83
pubmed:dateRevised
2007-12-14
pubmed:meshHeading
pubmed-meshheading:16803503-Aged, pubmed-meshheading:16803503-Carcinoma, pubmed-meshheading:16803503-False Negative Reactions, pubmed-meshheading:16803503-False Positive Reactions, pubmed-meshheading:16803503-Female, pubmed-meshheading:16803503-Groin, pubmed-meshheading:16803503-Humans, pubmed-meshheading:16803503-Inguinal Canal, pubmed-meshheading:16803503-Likelihood Functions, pubmed-meshheading:16803503-Lymph Node Excision, pubmed-meshheading:16803503-Lymphatic Metastasis, pubmed-meshheading:16803503-Magnetic Resonance Imaging, pubmed-meshheading:16803503-Middle Aged, pubmed-meshheading:16803503-Neoplasm Staging, pubmed-meshheading:16803503-Observer Variation, pubmed-meshheading:16803503-Physical Examination, pubmed-meshheading:16803503-Predictive Value of Tests, pubmed-meshheading:16803503-Retrospective Studies, pubmed-meshheading:16803503-Sensitivity and Specificity, pubmed-meshheading:16803503-Vulvar Neoplasms
pubmed:articleTitle
Accuracy of magnetic resonance imaging of inguinofemoral lymph nodes in vulval cancer.
pubmed:affiliation
Department of Gynaecological Oncology, Birmingham Women's Hospital, Metchley Park Road, Birmingham B15 2TG, UK. dockavitasingh@yahoo.co.uk
pubmed:publicationType
Journal Article, Evaluation Studies