PD-0212 SURVIVAL AFTER PET/CT PLANNED CONCOMITANT BOOST (IMRT) TO LYMPH NODE METASTASIS IN PATIENTS WITH CERVICAL CANCER

5587 Background: Previosly, we reported the accuracy of positron emission tomography with 2-[fluorine18] fluoro-2-deoxy-D- glucose (FDG-PET) for detecting metastatic lymph node (LN) in cervical cancer (Eur J Cancer 2005: 41; 2086–92). The aim of this prospective study was to evaluate the accuracy of PET/CT for detecting lymph node metastasis in cervical cancer and to compare the accuracy between PET and PET/CT. Methods: From May 2002 to Jul 2006, 86 patients with untreated stage IB-IVA cervical cancer were enrolled. All patients underwent pretreatment clinical staging including PET (May 2002-Aug 2003, 54 patients) or PET/CT (Jan 2004-Jul 2006, 32 patients) followed by surgical staging including systematic pelvic and paraaortic lymph node (PLN and PALN) dissection. To enable region specific comparisons, PALN and PLN were divided into eight regions: both PALN, both common iliac areas, both external iliac areas, and both internal iliac/obturator areas. Each lymph node was sliced at 2-mm intervals perpendicular to the greatest dimension to maximize the likelihood of detecting micrometastases. All metastatic tumor size in each involved lymph node was measured. Histopathologic evaluation of lymph nodes was the diagnostic standard. The study protocol was approved by Institutioal Review Board, and a written informed consent was obtained. Results: A total of 688 LN regions were evaluated. The sensitivity, specificity, positive predictive value, and negative predictive value of PET and PET/CT are shown in Table 1 . As the metastatic tumor size increased, the sensitivity of PET and PET/CT was improved. Although there were no differences in sensitivity for detecting large sized (> 5mm or 10mm) metastatic tumor, PET/CT was more sensitive than PET for all pathologically proven LN metastasis which included small sized (< 5mm) metastatic tumor. Conclusions: PET/CT was more sensitive than PET for detecting small sized (<5mm) lymph node metastasis in cervical cancer. [Table: see text] No significant financial relationships to disclose.

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Unsuspected axillary lymph node metastasis of nasopharyngeal and cervical cancer on 18FDG PET/CT: a case report

Nuclear Medicine Review ◽

10.5603/nmr.2016.0032 ◽

2016 ◽

Vol 19 (B) ◽

pp. 20-21 ◽

Cited By ~ 1

Author(s):

Sungmin Kang

Keyword(s):

Cervical Cancer ◽

Case Report ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Axillary Lymph Node ◽

Axillary Lymph Node Metastasis ◽

Axillary Lymph ◽

Node Metastasis ◽

18Fdg Pet ◽

Pet Ct

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How should we stage and tailor treatment strategy in locally advanced cervical cancer? Imaging versus para-aortic surgical staging

International Journal of Gynecological Cancer ◽

10.1136/ijgc-2020-001351 ◽

2020 ◽

Vol 30 (9) ◽

pp. 1434-1443

Author(s):

Alejandra Martinez ◽

Martina Aida Angeles ◽

Denis Querleu ◽

Gwenael Ferron ◽

Christophe Pomel

Keyword(s):

Cervical Cancer ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Lymph Nodes ◽

Locally Advanced ◽

Surgical Staging ◽

Advanced Cervical Cancer ◽

Locally Advanced Cervical Cancer ◽

Node Metastasis ◽

Pet Ct

Para-aortic lymph node status at initial assessment is the most important prognostic factor and a key point for the therapeutic strategy in patients with locally advanced cervical cancer. Undiagnosed lymph node metastasis is a major clinical problem as the finding of positive para-aortic lymph nodes leads to treatment modification, with a possible impact on disease free survival. When aortic lymph node disease is discovered, radiotherapy is extended to the para-aortic area, and other treatment modalities may be considered. Fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) is the most accurate imaging examination to assess para-aortic extension in patients with locally advanced cervical cancer. The gold standard to identify para-aortic extension remains histologic evaluation of the lymph nodes. Indeed, PET/CT fails to detect approximately 10–15% of patients with negative PET/CT aortic nodes who have lymph node metastasis on pathologic staging. Patients with positive pelvic lymph nodes have para-aortic extension in 25–30% of cases, and surgical staging will lead to treatment modification and probably to improved para-aortic and distant control. Surgical staging also avoids unnecessary toxicity associated with extended field radiation in approximately 75% of patients with pelvic lymph node metastasis. The best modality to identify para-aortic extension is histological evaluation of the lymph nodes, but the survival benefit of surgical staging remains controversial. On the other hand, current studies include a majority of patients without pelvic lymph node spread, who are likely to be those who will benefit the least from surgical staging.

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Lymph Node Metastasis in Patients with Clinical Early-Stage Cervical Cancer: Detection with Integrated FDG PET/CT

Radiology ◽

10.1148/radiol.2381041799 ◽

2006 ◽

Vol 238 (1) ◽

pp. 272-279 ◽

Cited By ~ 207

Author(s):

Sandro Sironi ◽

Alessandro Buda ◽

Maria Picchio ◽

Patrizia Perego ◽

Rossella Moreni ◽

...

Keyword(s):

Cervical Cancer ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Cancer Detection ◽

Fdg Pet ◽

Early Stage ◽

Node Metastasis ◽

Pet Ct ◽

Early Stage Cervical Cancer ◽

Fdg Pet Ct

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Utility of PET-CT to evaluate retroperitoneal lymph node metastasis in advanced cervical cancer: Results of ACRIN6671/GOG0233 trial

Gynecologic Oncology ◽

10.1016/j.ygyno.2016.05.002 ◽

2016 ◽

Vol 142 (3) ◽

pp. 413-419 ◽

Cited By ~ 27

Author(s):

Mostafa Atri ◽

Zheng Zhang ◽

Farrokh Dehdashti ◽

Susanna I. Lee ◽

Shamshad Ali ◽

...

Keyword(s):

Cervical Cancer ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Advanced Cervical Cancer ◽

Retroperitoneal Lymph Node ◽

Node Metastasis ◽

Pet Ct

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Preoperative risk assessment model for identification of lymph node metastasis in early cervical cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.15_suppl.5600 ◽

2013 ◽

Vol 31 (15_suppl) ◽

pp. 5600-5600

Author(s):

Seung-Hyuk Shim ◽

Dae-Yeon Kim ◽

Shin-Wha Lee ◽

Jeong-Yeol Park ◽

Jong-Hyeok Kim ◽

...

Keyword(s):

Cervical Cancer ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Assessment Model ◽

Concordance Index ◽

Preoperative Risk ◽

Good Discrimination ◽

Node Metastasis ◽

Pet Ct ◽

Early Cervical Cancer

5600 Background: The aim of this study was to develop a preoperative risk prediction model for lymph node metastasis in patients with early cervical cancer. Methods: The medical records of 504 patients with early cervical cancer who underwent hysterectomy and pelvic/paraaortic lymphadenectomy between 2007and 2012 in our center were retrospectively reviewed. According to the order of surgery performed, data between 2007 and 2010 were allocated to a model development cohort (n=314), and data between 2011 and 2012 were allocated to an external validation cohort (n=190). By using preoperative clinicopathologic data, magnetic resonance imaging (MRI) data, and positron emission/computed tomography (PET/CT) data, a multivariate logistic model was created. Based on this model, predictive nomogram was developed and externally validated. Results: Age, tumor size measured by MRI, and lymph node metastasis on PET/CT were found to be independent risk factors for nodal metastasis. Developed nomogram incorporating these three predictors showed good discrimination and calibration, with a bootstrap-adjusted concordance index of 0.772. Also, the validation set showed good discrimination with a bootstrap-adjusted concordance index of 0.783. Conclusions: We have developed a robust model to predict lymph node metastasis in patients with early cervical cancer. This new tool may be useful to clinicians and patients when deciding lymphadenectomy and maybe useful in designing clinical trials. [Table: see text]

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