ArticleBMC cancer2025
Concordance between MRI and clinical examination in cervical cancer staging: a retrospective study.
Article in BMC cancer, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- The challenges of implementing less invasive surgical management for cervical cancer in a limited-resource setting in Botswana: A case series.Gynecologic oncology reports · 2026Article
- Multimodality therapy for stage IB3 cervical cancer with a delayed diagnosis at 21 weeks of gestation: from neoadjuvant chemotherapy to adjuvant chemoradiotherapy-a case report.Frontiers in medicine · 2026Article
- Assessing the Clinical Utility of MRI for Preoperative Staging of Early-Stage Cervical Cancer in a Limited-Resource Setting: A Retrospective Cohort Study from Botswana.Research square · 2025Article
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6 authors.
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Abstract
backgroundCervical cancer is a major public health challenge in Nepal, with delayed diagnosis due to limited screening and infrastructure. Accurate staging, critical for treatment planning, integrates MRI with clinical examination (CE) per 2018 FIGO guidelines. This study evaluates MRI-CE concordance in staging cervical cancer at a Nepalese tertiary center, hypothesizing moderate agreement with MRI detecting occult spread missed by CE.
methodsThis retrospective study (2020-2023) included 76 patients with histologically confirmed cervical cancer and complete MRI (1.5T, T2/DWI/post-contrast) and CE (pelvic exam, punch/cone biopsy) data at Purbanchal Cancer Hospital. Staging followed FIGO 2018 guidelines. Univariate analyses summarized patient profiles; MRI sensitivity, PPV, and Cohen's κ assessed concordance. Missing treatment data (48.7%) were categorized as follow-up/remission cases.
resultsOf 76 patients (median age 50-59 years), 88.2% had squamous cell carcinoma; Stage IIB predominated (47.4%). MRI-CE concordance was 63.2% (κ = 0.58, 95% CI: 0.42-0.74). MRI upstaged 12 cases (15.8%), detecting parametrial (58.3%) or nodal involvement (41.7%), and downgraded 16 (21.1%), often underestimating stromal invasion (37.5%). MRI sensitivity was 63.2%; PPV was 75%. Treatment data, available for 39 patients, showed lower-than-expected CCRT/ICBT use due to resource constraints.
conclusionMRI complements CE by enhancing staging accuracy, particularly for occult spread, but does not replace it in resource-limited settings. Standardized MRI protocols and prospective studies are needed to optimize diagnostic and therapeutic outcomes in Nepal.
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