Detecting para-aortic lymph nodal metastasis by positron emission tomography of 18F-fluorodeoxyglucose in advanced cervical cancer with negative magnetic resonance imaging findings

2002 ◽  
Author(s):  
Lian-Shung Yeh ◽  
Yao-Ching Hung ◽  
Yeh-You Shen ◽  
Chia-Hung Kao ◽  
Cheng-Chieh Lin ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Cervical Cancer ◽  
Positron Emission Tomography ◽  
Nodal Metastasis ◽  
Emission Tomography ◽  
Advanced Cervical Cancer ◽  
Imaging Findings ◽  
Resonance Imaging ◽  
Positron Emission ◽  
Negative Magnetic Resonance Imaging

Prospective Multicenter Study Evaluating the Survival of Patients With Locally Advanced Cervical Cancer Undergoing Laparoscopic Para-Aortic Lymphadenectomy Before Chemoradiotherapy in the Era of Positron Emission Tomography Imaging

2013 ◽  
Vol 31 (24) ◽  
pp. 3026-3033 ◽  
Author(s):  
Sebastien Gouy ◽  
Philippe Morice ◽  
Fabrice Narducci ◽  
Catherine Uzan ◽  
Alejandra Martinez ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Positron Emission Tomography ◽  
Locally Advanced ◽  
Nodal Metastasis ◽  
Emission Tomography ◽  
Advanced Cervical Cancer ◽  
Nodal Involvement ◽  
Prospective Multicenter Study ◽  
Locally Advanced Cervical Cancer ◽  
Positron Emission

Purpose The aim of this prospective study conducted in three French comprehensive cancer centers was to evaluate the therapeutic impact on survival of laparoscopic para-aortic (PA) staging surgery in locally advanced cervical cancer (LACC) before chemoradiotherapy. Patients and Methods We conducted a prospective multicenter study of 237 patients treated from 2004 to 2011 for LACC with negative positron emission tomography (PET) imaging of the PA area and undergoing laparoscopic PA lymphadenectomy. Radiation fields were extended to the PA area when PA nodes were involved. Chemoradiotherapy modalities were homogeneous across institutions. Patients with a poor prognosis histologic subtype or peritoneal carcinosis were excluded. Results Patients had clinical International Federation of Gynecology and Obstetrics stages IB2 (n = 79), IIA (n = 10), IIB (n = 121), III (n = 22), or IVA (n = 5). One hundred ninety-nine patients had squamous carcinoma, and 38 had adenocarcinoma/adenosquamous lesions. Twenty-nine patients (12%) had nodal involvement (false-negative PET–computed tomography [CT] results)—16 with a PA nodal metastasis measuring more than 5 mm and 13 with a nodal metastasis measuring ≤ 5 mm. Event-free survival rates at 3 years in patients without PA involvement or with PA metastasis measuring ≤ or more than 5 mm were 74% (SE, 4%), 69% (SE, 21%), and 17% (SE, 14%; P < .001). Conclusion To our knowledge, this is the largest series of patients reported undergoing such a strategy. We obtained the same survival rate for patients with PA nodal metastasis ≤ 5 mm and patients without PA lymph node involvement, suggesting that this strategy is highly efficient in such patients. Conversely, the survival of patients with PA nodal involvement greater than 5 mm remained poor, despite the absence of extrapelvic disease on PET-CT imaging in this subgroup.

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