INTERSTITIAL FLUID PRESSURE IN CERVICAL-CARCINOMA - WITHIN TUMOR HETEROGENEITY, AND RELATION TO OXYGEN-TENSION

BACKGROUND. Interstitial fluid pressure (IFP) is elevated in many anim al and human tumors. The authors assessed tumor IFP and its relation t o tumor oxygenation in a prospective clinical study of patients with c ervical carcinoma. METHODS. Measurements were made in 77 patients with cervical carcinoma prior to treatment. IFP was measured in normal par avaginal submucosal tissue and at one to five positions in the visible tumor with the patients anesthetized and in the lithotomy position. T umor oxygen tension was measured immediately prior to IFP using a pola rographic needle electrode. Patients were treated with radiotherapy on ly. Response was evaluated 3 months after the completion of radiothera py. RESULTS. There was substantial variation in IFP from region to reg ion in some tumors. The mean IFP in individual tumors ranged from 3 to 48 millimeters of mercury (mmHg). The overall mean and median values for the entire patient group were 19 mmHg and 17 mmHg, respectively. I FP was significantly higher in tumor tissue than in normal tissue (P < 0.0001). Tumors with high IFP were more likely to be hypoxic (P < 0.0 07) and less likely to regress completely with radiotherapy (P < 0.04) . CONCLUSIONS. IFP in cervical carcinoma is elevated above normal tiss ue values. Multiple measurements are needed to evaluate IFP in these t umors. High IFP is associated with hypoxia and may provide information about the mechanism of hypoxia on which treatment can be based. (C) 1 998 American Cancer Society.