Peritumoral interstitial fluid flow velocity predicts survival in cervical carcinoma

Radiother Oncol. 2014 Oct;113(1):132-8. doi: 10.1016/j.radonc.2014.09.011. Epub 2014 Oct 15.


Background and purpose: High tumor interstitial fluid pressure (IFP) is associated with poor outcome in locally advanced carcinoma of the uterine cervix. We have recently developed a noninvasive assay of the IFP of tumors, and in this assay, the outward interstitial fluid flow velocity at the tumor surface (v0) is measured by Gd-DTPA-based DCE-MRI and used as a parameter for IFP. Here, we investigated the independent prognostic significance of v0 in cervical cancer patients given cisplatin-based concurrent chemoradiotherapy with curative intent.

Patients: The study involved 62 evaluable patients from a cohort of 74 consecutive patients (Stage IB through IIIB) with a median follow-up of 5.5 years.

Results: The actuarial disease-free survival (DFS) and overall survival (OS) at 5 years were 67% and 76%, respectively. Significant associations were found between v0 dichotomized about the median value and DFS and OS, both in the total patient cohort and a subcohort of 40 Stage IIB patients. Multivariate analysis involving stage, tumor volume, lymph node status, and v0 revealed that only v0 provided independent prognostic information about DFS and OS.

Conclusion: This investigation demonstrates a strong, independent prognostic impact of the pretreatment peritumoral fluid flow velocity in cervical cancer.

Keywords: Cervical carcinoma; DCE-MRI; Disease-free and overall survival; Interstitial fluid pressure; Peritumoral fluid flow.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Agents / therapeutic use
  • Chemoradiotherapy / methods*
  • Cisplatin / therapeutic use
  • Contrast Media
  • Disease-Free Survival
  • Extracellular Fluid / physiology*
  • Female
  • Gadolinium DTPA
  • Humans
  • Lymphatic Metastasis
  • Magnetic Resonance Imaging
  • Middle Aged
  • Multivariate Analysis
  • Pressure
  • Prognosis
  • Tumor Burden
  • Uterine Cervical Neoplasms / mortality
  • Uterine Cervical Neoplasms / physiopathology
  • Uterine Cervical Neoplasms / therapy*


  • Antineoplastic Agents
  • Contrast Media
  • Gadolinium DTPA
  • Cisplatin