http://hdl.handle.net/10171/18921 Wed, 19 Jun 2013 16:25:50 GMT 2013-06-19T16:25:50Z http://hdl.handle.net/10171/29250 Title: Embarazo a término en mujer con trasplante renal previo Author(s) : Purroy, A. (A.); Errasti, P. (Pedro); Otero, R. (R.); Alterkawi, A. (A.); Giron, J.J. (J.J.) Abstract: En esta comunicación se presenta la evolución de un embarazo, con parto prematuro de 33-34 semanas, en una enferma que previamente había recibido un trasplante renal. Sat, 31 Dec 1977 23:00:00 GMT http://hdl.handle.net/10171/29250 1977-12-31T23:00:00Z http://hdl.handle.net/10171/27540 Title: Is expectant management of sonographically benign adnexal cysts an option in selected asymptomatic premenopausal women? Author(s) : Alcazar, J.L. (Juan Luis); Castillo, G. (G.); Jurado, M. (M.); Lopez-Garcia, G. (Guillermo) Abstract: The objective was to assess whether expectant management of sonographically benign ovarian cysts may be an option for selected asymptomatic premenopausal women. METHODS: This is a prospective observational longitudinal study. Between January 1997 and December 2002, 323 asymptomatic premenopausal women (mean age: 40.6 years; range: 19-50 years) diagnosed as having a sonographically benign ovarian cyst measuring <6 cm were offered conservative management with periodic follow-up at 6-12 month intervals. In all cases, a first check was performed 3 months after diagnosis to confirm the 'persistent' nature of the cyst. A total of 120 women agreed to participate in this study and constitute the basis of the data presented. RESULTS: Mean diameter at diagnosis for the most frequent lesions were as follows: endometrioma 3.3 cm (SD 1.5); simple cyst 4.1 cm (SD 1.6); dermoid cyst 3.2 cm (SD 1.4); haemorrhagic cyst 3.5 cm (SD 1.2); hydrosalpinx 2.9 cm (SD 1.0). With a median follow-up of 42 months (range: 18-94 months), most lesions remained unchanged, both in size and sonographic appearance. Ten cysts (8.3%) disappeared during follow-up, all of them after more than 2 years of follow-up. No patient has developed signs or symptoms suggesting ovarian cancer. CONCLUSION: Most sonographically benign ovarian cysts remain unchanged during long-term follow-up. Our data would support conservative management in these cases. Fri, 31 Dec 2004 23:00:00 GMT http://hdl.handle.net/10171/27540 2004-12-31T23:00:00Z http://hdl.handle.net/10171/23667 Title: Comparative study of transvaginal ultrasonography and CA 125 in the preoperative evaluation of myometrial invasion in endometrial carcinoma Author(s) : Alcazar, J.L. (Juan Luis); Jurado, M. (M.); Lopez-Garcia, G. (Guillermo) Abstract: To compare the ability of transvaginal sonography and serum CA 125 levels to predict myometrial invasion in patients with endometrial carcinoma. DESIGN AND METHODS: Prospective study in 50 consecutive patients (mean age 60 years, SD 10.5, range 29-77 years) diagnosed as having endometrial cancer and scheduled for surgical staging. All patients were evaluated by transvaginal ultrasonography. Endometrial thickness was measured in all cases and myometrial invasion was estimated as < 50% or > or = 50%. Serum CA 125 level was determined in each patient. A cut-off level of > or = 35 IU/ml was considered to predict myometrial invasion of > or = 50%. All patients underwent surgical staging, and definitive histopathological findings regarding myometrial invasion were used as the 'gold standard'. Sensitivity, specificity and positive predictive value (PPV) and negative predictive value (NPV) were calculated for transvaginal ultrasonography and CA 125 and compared. RESULTS: On histopathological analysis, myometrial invasion was found to be < 50% in 35 (70%) cases and > or = 50% in 15 cases (30%). Mean endometrial thickness in patients with superficial invasion was significantly lower than in those with deep invasion (13.4 mm (95% CI 11.2-15.7) vs. 18.7 mm (95% CI 15.0-22.3), respectively; p = 0.014). Median CA 125 was significantly higher in patients with deep invasion than in those with superficial invasion (30 IU/ml, interquartile range (IQR) 46.0 vs. 16.9 IU/ml, IQR 13.9, respectively; p = 0.002). The sensitivity, specificity, PPV and NPV for transvaginal ultrasonography were 86.7% (95% CI 59.5-98.3), 94.3% (95% CI 80.8-99.3), 86.7% (95% CI 59.5-98.3) and 94.3% (95% CI 80.8-99.3), respectively. The sensitivity, specificity, PPV and NPV for CA 125 were 40% (95% CI 16.3-67.7), 91.4% (95% CI 76.9-98.2), 66.7% (95% CI 29.9-92.5) and 78% (95% CI 63.4-89.5), respectively. The sensitivity of transvaginal ultrasonography was significantly higher than that of CA 125 (p = 0.008). No differences were found in terms of specificity, PPV or NPV. CONCLUSION: Our results indicate that transvaginal ultrasonography is more sensitive than CA 125 in predicting myometrial invasion in endometrial cancer. Thu, 31 Dec 1998 23:00:00 GMT http://hdl.handle.net/10171/23667 1998-12-31T23:00:00Z http://hdl.handle.net/10171/23508 Title: Transvaginal color Doppler sonography in adnexal masses: which parameter performs best? Author(s) : Alcazar, J.L. (Juan Luis); Ruiz-Perez, M.L. (M. L.); Errasti, T. (Tania) Abstract: The aim of this study was to establish which of several commonly used parameters performs best in the evaluation of adnexal masses by transvaginal color Doppler sonography. A total of 79 adnexal masses in 73 consecutive patients were included in the study. There were 43 (58.9%) premenopausal and 30 (41.1%) postmenopausal patients. The median age was 45 years (range 20-78 years). The parameters compared were: number of vessels detected in each tumor, tumor vessel location (central vs. peripheral), peak systolic velocity (PSV), lowest resistance index (RIlowest), mean resistance index (RImean), lowest pulsatility index (PIlowest) and mean pulsatility index (PImean). Receiver operating characteristic (ROC) curves were plotted to analyze the test performance of the parameters, except for tumor vessel location, and to estimate the best cut-off value of the parameters studied to differentiate between malignant and benign tumors. Definitive histopathological diagnosis was obtained in every case and used as the 'gold standard'. There were 20 (25.3%) malignant and 59 (74.7%) benign masses. Color Doppler signals were detected in 100% of the malignant masses (20 out of 20) and 74.6% (44 out of 59) of the benign masses, and the difference was found to be statistically significant (p < 0.001). Tumor vessel location was central in 18 out of 20 (90%) malignant masses, whereas it was peripheral in 39 out of 44 (88.6%) benign masses. ROC analysis showed that the best cut-off values for number of vessels, PSV, RIlowest, RImean, PIlowest and PImean were three vessels, 25 cm/s, 0.45, 0.55, 0.90 and 1.50, respectively. However, for all these parameters except RIlowest, there was a considerable overlap between benign and malignant tumors, with a high false-positive rate. In conclusion, in our experience, the parameters that performed best were the RIlowest with a cut-off value of 0.45 (sensitivity 100%; false-positive rate 11.4%) and central tumor vessel location (sensitivity 90%; false-positive rate 11.4%). Sun, 31 Dec 1995 23:00:00 GMT http://hdl.handle.net/10171/23508 1995-12-31T23:00:00Z http://hdl.handle.net/10171/23503 Title: Transvaginal ultrasonography combined with color velocity imaging and pulsed Doppler to detect residual trophoblastic tissue Author(s) : Alcazar, J.L. (Juan Luis) Abstract: The value of transvaginal B-mode ultrasonography combined with color velocity imaging and pulsed Doppler to detect retained trophoblastic tissue was evaluated prospectively in a series of 40 patients with postpartum (n = 15) or postabortion (n = 25) bleeding. Color velocity imaging was used to identify color-coded blood flow signals within myometrium and/or endometrium. Flow was subjectively quantified as absent, scanty or abundant. Pulsed Doppler was used to assess blood flow impedance by calculating the resistance index. The presence of abundant flow with a lowest resistance index of less than 0.45 was considered as suspicious of residual trophoblastic tissue. Twenty-two (55%) out of the 40 patients underwent dilatation and curettage and chorionic villi were demonstrated in 15 of these. Eighteen (45%) patients were managed conservatively. None of these patients suffered complications or needed readmission for curettage, and all of them were considered as not having retained tissue. On color pulsed Doppler ultrasound examination, 15 patients had suspected retained tissue; all of these underwent curettage and residual trophoblast was found in 14 (93.3%). Out of 25 patients considered as having no residual tissue on color pulsed Doppler ultrasound examination, seven underwent curettage and chorionic villi were found in one patient (false-negative rate 6.7%) All patients managed conservatively had an unsuspicious scan. We concluded that transvaginal ultrasonography combined with color velocity imaging and pulsed Doppler could be useful to detect retained trophoblastic tissue and to select patients suitable for conservative management. Wed, 31 Dec 1997 23:00:00 GMT http://hdl.handle.net/10171/23503 1997-12-31T23:00:00Z http://hdl.handle.net/10171/23502 Title: Endometrial blood flow mapping using transvaginal power Doppler sonography in women with postmenopausal bleeding and thickened endometrium Author(s) : Alcazar, J.L. (Juan Luis); Castillo, G. (G.); Minguez, J.A. (J. A.); Galan, M.J. (M. J.) Abstract: Objective To evaluate the role of transvaginal power Doppler sonography to discriminate between benign and malignant endometrial conditions in women presenting with postmenopausal bleeding and thickened endometrium at baseline sonography. Methods Ninety-one postmenopausal women (median age, 58 years; range, 47–83 years) presenting with uterine bleeding and a thickened endometrium (≥5-mm doublelayer endometrial thickness) on transvaginal sonography were included in this prospective study. Endometrial blood flow distribution was assessed in all patients by power Doppler immediately after B-mode transvaginal sonography. Three different vascular patterns were defined: Pattern A: multiple-vessel pattern, Pattern B: single-vessel pattern and Pattern C: scattered-vessel pattern. Histological diagnoses were obtained in all cases. No patient taking tamoxifen citrate or receiving hormone replacement therapy was included. Results Histological diagnoses were as follows: endometrial cancer: 33 (36%), endometrial polyp: 37 (41%), endometrial hyperplasia: 14 (15%), endometrial cystic atrophy: 7 (8%). Blood flow was found in 97%, 92%, 79% and 85% of cases of carcinoma, polyp, hyperplasia and endometrial cystic atrophy, respectively. A total of 81.3% of vascularized endometrial cancers showed Pattern A, 97.1% of vascularized polyps exhibited Pattern B and 72.7% of vascularized hyperplasias showed Pattern C. Sensitivity and specificity for endometrial cancer were 78.8% and 100%. For endometrial polyp these respective values were 89.2% and 87% and for hyperplasia they were 57.1% and 88.3%. Conclusions Transvaginal power Doppler blood flow mapping is useful to differentiate benign from malignant endometrial pathology in women presenting with postmenopausal bleeding and thickened endometrium at baseline sonography. Tue, 31 Dec 2002 23:00:00 GMT http://hdl.handle.net/10171/23502 2002-12-31T23:00:00Z http://hdl.handle.net/10171/23422 Title: Three-dimensional ultrasound assessment of endometrial receptivity: a review Author(s) : Alcazar, J.L. (Juan Luis) Abstract: Three-dimensional ultrasound (3D US) is a new imaging modality, which is being introduced into clinical practice. Although this technique will not probably replace two-dimensional ultrasound, it is being increasingly used. It has been reported that 3D US is a very high reproducible technique. The endometrium has been paid special attention when using this technique. The aim of this paper is to address some technical aspects of 3D US and to review critically its current status in evaluating endometrial function with special focus in its role in predicting pregnancy in assisted reproductive techniques. In spontaneous cycles endometrial volume grows during follicular phase remaining constant through the luteal phase. Endometrial vascularization increases during follicular phase peaking 2–3 days before ovulation, decreasing thereafter and increasing again during mid and late luteal phase. Data from studies analysing the role of 3D US for predicting IVF outcome are controversial. An explanation for these controversial findings might be different design of reported studies, specially the timing of ultrasound evaluation. Sat, 31 Dec 2005 23:00:00 GMT http://hdl.handle.net/10171/23422 2005-12-31T23:00:00Z http://hdl.handle.net/10171/23357 Title: Transvaginal colour Doppler in patients with ovarian endometriomas and pelvic pain Author(s) : Alcazar, J.L. (Juan Luis) Abstract: The aim of this investigation was to correlate ovarian endometrioma vascularization with the presence of pelvic pain. METHODS: The presence of blood flow, peak systolic velocity (PSV, cm/s) and lowest pulsatility index (PI), assessed by transvaginal colour Doppler ultrasonography and CA-125 plasma concentrations, were retrospectively analysed in 74 patients who had undergone operations for cystic ovarian endometriosis. Fifty-two patients were asymptomatic (group A) and 22 presented with pelvic pain (group B). There were 56 endometriomas in group A and 26 in group B. RESULTS: Blood flow was found in 66.1 and 88.5% of endometriomas in groups A and B respectively (P = 0.036). PI was significantly lower (P = 0.009) and CA-125 concentration higher (P = 0.0004) in group B. There were no differences in PSV. CONCLUSIONS: We conclude that vascularization of ovarian endometriomas in patients presenting with pelvic pain is higher than in asymptomatic patients. This could be an indicator of endometriosis activity. Sun, 31 Dec 2000 23:00:00 GMT http://hdl.handle.net/10171/23357 2000-12-31T23:00:00Z http://hdl.handle.net/10171/23339 Title: Tumor angiogenesis assessed by three-dimensional power Doppler ultrasound in early, advanced and metastatic ovarian cancer: a preliminary study Author(s) : Alcazar, J.L. (Juan Luis) Abstract: Objective To evaluate tumor vascularity by threedimensional power Doppler ultrasound (3D-PDU) in early and advanced stage primary ovarian cancers and in metastatic tumors to the ovary. Patients and methods This was a retrospective analysis of clinical and sonographic data from 49 women with primary ovarian cancers or metastatic tumors to the ovary. All women underwent 3D-PDU prior to surgery. Vascularization index (VI), flow index (FI) and vascularization flow index (VFI) from solid portions or papillary projections in the tumors were calculated using the Virtual Organ Computer-aided AnaLysis (VOCALTM) program. Definitive histological diagnosis was obtained in each case. Results Among the 49 women, 10 had stage I primary cancers (five low-malignant potential tumors and five invasive tumors), 26 had advanced stage primary ovarian cancers and 13 had metastatic tumors to the ovary. Mean VI and VFI were significantly higher in advanced stage tumors and metastatic tumors as compared with early stage tumors. No differences in 3D-PDU indices were found between advanced stage and metastatic cancers. Conclusions Vascular indices derived from 3D-PDU tend to be higher in advanced stage and metastatic ovarian cancers as compared with early stage ovarian tumors. Sat, 31 Dec 2005 23:00:00 GMT http://hdl.handle.net/10171/23339 2005-12-31T23:00:00Z http://hdl.handle.net/10171/22956 Title: Two-dimensional power Doppler-three-dimensional ultrasound imaging of a cesarean section dehiscence with utero-peritoneal fistula: a case report Author(s) : Royo, P. (Pedro); Garcia-Manero, M. (Manuel); Olartecoechea, B. (Begoña); Alcazar, J.L. (Juan Luis) Abstract: Introduction: An imaging diagnosis after an iterative cesarean delivery is reviewed demonstrating a fine ultrasound-pathologic correlation. Case presentation: A 33-year-old woman (G3, P3) presented referring intense dysmenorrhea and intermenstrual spotting since her third cesarean delivery, 1 year before. A cesarean section dehiscence with utero-peritoneal fistula was diagnosed by transvaginal ultrasound. Conclusion: We can conclude that transvaginal two-dimensional power Doppler and threedimensional ultrasound are highly accurate in detecting cesarean section dehiscence and uterine fistula. Wed, 31 Dec 2008 23:00:00 GMT http://hdl.handle.net/10171/22956 2008-12-31T23:00:00Z http://hdl.handle.net/10171/22915 Title: Assessing myometrial infiltration by endometrial cancer: uterine virtual navigation with three-dimensional US Author(s) : Alcazar, J.L. (Juan Luis); Galvan, R. (R.); Albela, S. (Sonia); Martinez, S. (Sergio); Pahisa, J. (Jaume); Jurado, M. (M.); Lopez-Garcia, G. (Guillermo) Abstract: To describe and analyze the diagnostic performance of uterine virtual navigation with three-dimensional (3D) ultrasonography (US) for the assessment of the depth of myometrial infiltration by endometrial cancer. MATERIALS AND METHODS: Institutional review board approval was obtained; patients gave oral informed consent. Women with endometrial cancer were evaluated by using 3D US prior to surgical staging. A 3D volume of the whole uterus was obtained and analyzed by using software. Virtual navigation through three orthogonal planes was performed to identify the shortest myometrial tumor-free distance to serosa (TDS) by analyzing the lateral, anterior, posterior, and fundal portions of the myometrium. Myometrial infiltration was also assessed by subjective impression of an examiner. Histologic findings of myometrial infiltration and TDS measured by a pathologist were used as the reference standard. A receiver operating characteristic curve was plotted to identify the best cutoff for TDS for identifying myometrial infiltration of 50% or more. RESULTS: Ninety-six women (mean age, 61.8 years; range, 31-86 years) with endometrial cancer were included in the study. At histologic analysis, myometrial invasion was found to be less than 50% in 69 (72%) cases and 50% or more in 27 (28%) cases. TDS measured with US was positively correlated with histologically measured TDS (r = 0.649; 95% confidence interval: 0.52, 0.76). The best cutoff for US-measured TDS was 9.0 mm (sensitivity, 100%; specificity, 61%; negative predictive value, 100%; positive predictive value, 50%). Subjective impression had a sensitivity of 92.6%, a specificity of 82.3%, a negative predictive value of 96.6%, and a positive predictive value of 67.7%. CONCLUSION: Uterine virtual navigation with 3D US is a reliable method for the assessment of myometrial infiltration in patients with endometrial cancer. Wed, 31 Dec 2008 23:00:00 GMT http://hdl.handle.net/10171/22915 2008-12-31T23:00:00Z http://hdl.handle.net/10171/22902 Title: Evaluation of two different methods for vascular sampling by three-dimensional power Doppler angiography in solid and cystic-solid adnexal masses Author(s) : Alcazar, J.L. (Juan Luis); Prka, M. (M.) Abstract: Objective To analyze two different methods for performing three-dimensional power Doppler angiography (3D-PDA) vascular sampling in solid and cystic-solid adnexal masses. Methods Twenty-one 3D-PDA volumes from 18 consecutive and unselected solid or cystic-solid adnexal masses (13 malignant and five benign) were analyzed. A single examiner (J. L. A.) acquired all the volumes according to a predetermined scanning protocol. Two different observers (one inexperienced and the other experienced) calculated 3D-PDA vascular indices (vascularization index (VI), flow index (FI) and vascularization flow index (VFI)) from solid tumor areas. First, manual sampling (Plane A, 15◦ rotation-step) was performed, and 1 week later 5-cm3 sphere sampling from the most vascularized area was carried out. The observers made a record of any difficulty that they encountered in delineating the solid areas of tumors or in distinguishing true tumor vessels from preexisting vessels, the time spent performing each analysis was recorded and inter- and intraobserver reproducibility was evaluated for each method using intraclass correlation coefficients (ICC). Results In four (19.0%) of the 21 volumes sphere sampling could not be performed because it was not possible to obtain a sphere smaller than 5.5 cm3. This happened in cases in which image zooming was used when acquiring the 3D volume. The inexperienced observer encountered more difficulty, but not significantly more, than the experienced observer when analyzing 3D-PDA volumes both by manual sampling (29% vs. 14% of cases) and 5-cm3 sphere sampling (35% vs. 18% of cases). The mean time spent by the inexperienced observer was significantly greater (P < 0.001) than that spent by the experienced observer both for manual sampling (6.11 min vs. 1.85 min) and 5-cm3 sphere sampling (2.93 min vs. 2.15 min). Contrary to the findings for the experienced observer, the inexperienced observer required less time to perform sphere sampling than they did manual sampling. Interobserver agreement was high for both methods: ICC for manual volume, 0.993; manual VI, 0.908; manual FI, 0.913; manual VFI, 0.914; sphere volume, 0.949; sphere VI, 0.954; sphere FI 0.850; and sphere VFI, 0.953. Intraobserver reproducibility was also high, with all ICCs above 0.99. Conclusions Manual and 5-cm3 sphere sampling are reproducible methods for 3D-PDA vascular sampling. Caution is required when image zoom is used at the time of acquiring the volume because this may prevent sphere sampling. Difficulties found in performing both manual and sphere sampling do not seem to significantly affect the reproducibility of Doppler index calculations. Wed, 31 Dec 2008 23:00:00 GMT http://hdl.handle.net/10171/22902 2008-12-31T23:00:00Z http://hdl.handle.net/10171/22893 Title: Triage for surgical management of ovarian tumors in asymptomatic women: assessment of an ultrasound-based scoring system. Author(s) : Alcazar, J.L. (Juan Luis); Royo, P. (Pedro); Jurado, M. (M.); Minguez, J.A. (J.A.); Garcia-Manero, M. (Manuel); Laparte, C. (C.); Galvan, R. (R.); Lopez-Garcia, G. (Guillermo) Abstract: OBJECTIVES: To prospectively evaluate an ultrasound-based scoring system as a method for triaging asymptomatic women presenting with an adnexal mass for surgical treatment. METHODS: Two hundred and four adnexal masses in 189 asymptomatic women undergoing elective surgical treatment at our institution were included in this prospective study. Patients were evaluated by transvaginal power Doppler ultrasound imaging before surgery. Patients were classified as low risk or high risk for malignancy according to an ultrasound-based scoring system. Women with a low risk for malignancy were scheduled for laparoscopy and patients with a high risk for malignancy were scheduled for laparotomy. However, patients classified as low risk by the ultrasound scoring system, but with a tumor size >or= 10 cm or clinical suspicion of pelvic adhesions, were instead considered to be at intermediate risk and were scheduled for laparotomy. Some patients classified as high risk were scheduled for an operative laparoscopy by an expert in gynecological oncology. RESULTS: One hundred and thirty-four (65.7%) masses were considered to be low risk and were treated by a laparoscopically guided procedure. All these tumors were benign. Forty-seven (23%) masses were classified as high risk, of which 39 tumors were malignant and eight benign. Twenty-three (11.3%) tumors were considered to be intermediate risk and were scheduled for primary laparotomy. In this group, 21 (91.3%) tumors proved to be benign and two (8.7%) were malignant. CONCLUSIONS: Ultrasound-based triage of asymptomatic women diagnosed with a persistent adnexal mass is effective for selecting the surgical approach. Mon, 31 Dec 2007 23:00:00 GMT http://hdl.handle.net/10171/22893 2007-12-31T23:00:00Z http://hdl.handle.net/10171/22875 Title: Three-dimensional power Doppler derived vascular indices: what are we measuring and how are we doing it? Author(s) : Alcazar, J.L. (Juan Luis) Mon, 31 Dec 2007 23:00:00 GMT http://hdl.handle.net/10171/22875 2007-12-31T23:00:00Z http://hdl.handle.net/10171/22870 Title: Neoangiogenesis in early cervical cancer: Correlation between color Doppler findings and risk factors. A prospective observational study Author(s) : Jurado, M. (M.); Galvan, R. (R.); Martinez-Monge, R. (Rafael); Mazaira, J. (Jesús); Alcazar, J.L. (Juan Luis) Abstract: Background: The aim of the present article was to evaluate whether angiogenic parameters as assessed by transvaginal color Doppler ultrasound (TVCD) may predict those prognostic factors related to recurrence. Methods: A total of 27 patients (mean age: 51.3 years, range: 29 to 85) with histologically proven early stage invasive cervical cancer were evaluated by TVCD prior to surgery. Subjective assessment of the amount of vessels within the tumor (scanty-moderate or abundant) and pulsatility index (PI) were recorded. All patients underwent radical hysterectomy and pelvic lymph node dissection. Postoperative treatment (RT or chemoradiotherapy) was given according to risk factors (positive lymph nodes, parametrial and vaginal margin involvement, depth stromal invasion, lymph-vascular space involvement) Results: Tumors with "abundant" vascularization were significantly associated with pelvic lymph node metastases, depth stromal invasion > 10 mm, lymph-vascular space involvement, tumor diameter > 17.5 mm, and parametrial involvement. Postoperative treatment was significantly more frequent in patients with "abundant" vascularization (OR: 20.8, 95% CIs: 2 to 211). The presence of scanty-moderate vascularization with a PI < 0.82 or abundant vascularization with either PI > 0.82 or PI < 0.82 was associated with high-risk group in 94.4% of the cases (OR: 21.2, 95% CI: 1.9 to 236.0) Conclusion: The results are consistent with a relationship between tumor angiogenesis and prognostic factors for recurrence in early cervical cancer. "Abundant" vascularization and PI < 0.82 may be related to postoperative treatment due to risk factors. Mon, 31 Dec 2007 23:00:00 GMT http://hdl.handle.net/10171/22870 2007-12-31T23:00:00Z