FDG-PET in carcinoma of the uterine cervix with endometrial extension.
BACKGROUND
The authors wished to determine whether pretreatment pathologic evidence of endometrial invasion correlated with fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) findings and outcomes in patients with carcinoma of the uterine cervix.


METHODS
Pretreatment whole body FDG-PET was performed in 58 patients with cervical carcinoma who also underwent pathologic evaluation of the endometrium by biopsy or dilation and curettage. FDG-PET lymph node status, disease free survival, and overall survival were evaluated.


RESULTS
Thirty seven (64%) patients had pathologic evidence of endometrial invasion. Pelvic lymph node metastases were three times more frequent in patients with evidence of endometrial invasion compared with those without endometrial invasion (70% vs. 23%, P < 0.001). Patients with endometrial invasion also had a significantly increased risk of paraaortic and supraclavicular lymph node metastases at presentation (30% vs. 0% P = 0.006). Endometrial invasion was associated with a decreased 2-year disease-free survival (78% vs. 58%, P = 0.046) and overall survival (92% vs. 65%, P = 0.047).


CONCLUSIONS
Endometrial extension in cervical cancer correlated strongly with risk of FDG-PET detected lymph node metastases in this study's population and was associated with a poor prognosis.
Hope
Andrew J
AJ
Department of Radiation Oncology, Washington University School of Medicine, St. Louis, Missouri 63110, USA.
Saha
Paban
P
Grigsby
Perry W
PW
D000230:Adenocarcinoma / Q000000981:diagnostic imaging* / Q000401:mortality / Q000556:secondary / Q000628:therapy; D018196:Carcinoma, Adenosquamous / Q000000981:diagnostic imaging / Q000401:mortality / Q000556:secondary / Q000628:therapy; D018278:Carcinoma, Neuroendocrine / Q000000981:diagnostic imaging* / Q000401:mortality / Q000556:secondary / Q000628:therapy; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging* / Q000401:mortality / Q000556:secondary / Q000628:therapy; D002584:Cervix Uteri / Q000000981:diagnostic imaging / Q000473:pathology; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D016889:Endometrial Neoplasms / Q000000981:diagnostic imaging* / Q000401:mortality / Q000473:pathology / Q000628:therapy; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008207:Lymphatic Metastasis; D009361:Neoplasm Invasiveness; D049268:Positron-Emission Tomography; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000000981:diagnostic imaging* / Q000401:mortality / Q000473:pathology / Q000628:therapy
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18