[Locoregional extension of advanced cancer of the uterine cervix:prospective evaluation of results of clinical examination, endocavitary ultrasonography, TDM, MRI and histology]. / Extension locorégionale des cancers avancés du col utérin: évaluation prospective des résultats de l'examen clinique, des échographies endocavitaires, de la TDM, de l'IRM et de l'histologie.

ABSTRACT

Between January 1988 and January 1991, 37 advanced cervical cancer patients were operated and explorated by clinical examination and endoluminal ultrasonography under general anesthesia (endovesical, endovaginal and endorectal US); tomodensitometry (26 cases); MR imaging (14 cases) and cytoscopy (33 cases). Results of these explorations have been compared with post-operative histopathology. Sensitivity, specificity, predictive values and accuracy of each exploration were calculated for several anatomical structures. Vesical posterior wall has been analysed in about 37 cases, vesico-vaginal structure in about 36 cases, rectal anterior wall and recto-vaginal structure in about 36 cases, parametrium and pelvic sides walls in about 35 cases. Accuracy for clinical examination, endoluminal US, TDM and IRM were respectively 76, 85, 73, 86%, and respectively 85% by cytoscopy for vesical posterior wall; 72, 88, 65, 78% for vesico-vaginal structure; 92, 97, 83, 64% for rectal anterior wall; 78, 94, 74, 57% for recto-vaginal structure; 84, 89, 69, 73% for vagina; 81, 78, 81, 81% for parametrium; 94%, 93% and 87.5% by TDM and IRM for pelvic side wall. Contribution of endoluminal US is effective for advanced cervical cancer loco-regional staging. Endoluminal US have a good accuracy, are realised under general anesthesia without any discomfort for patients and are little expensive.