Role of [18F]fluoro-2-deoxy-D-glucose positron emission tomography in re-recurrent cervical cancer.
Cervical cancer patients with histologically documented re-recurrence after curative salvage therapy or unexplained tumor marker elevation (negative computed tomography and/or magnetic resonance imaging [CT-MRI]) proven to be a re-recurrence when a further attempt for cure (or control of cancer) appeared feasible were enrolled. Lesion status was determined from pathology or clinical follow-up for at least 12 months. Management decisions were recorded with CT-MRI alone and incorporating [18F]fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET), respectively. The benefits calculated were based on clinical impact because of the FDG-PET findings. Cox proportional hazards model was used to select independent prognostic covariates. Of the 26 patients who were eligible for analysis, 12 (46.2%) patients had positive impacts due to PET. Squamous cell carcinoma (SCC, P = 0.029), re-recurrence at distant metastasis only (P = 0.012), and level of SCC antigen < or = 4 ng/mL (P = 0.005) were significantly associated with better survival. A scoring system using these covariates defined three distinct prognostic groups (P = 0.0001). Patients with score 0 had a 36-month cumulative survival rate of 80%. Using this prognostic scoring system, FDG-PET may facilitate selecting appropriate management for the individual patient with re-recurrent cervical cancer.
Lin
C-T
CT
Departments of Obstetrics and Gynecology, Nuclear Medicine, Diagnostic Radiology, and Radiation Oncology, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Yen
T-C
TC
Chang
T-C
TC
Ng
K-K
KK
Tsai
C-S
CS
Ho
K-C
KC
Lai
C-H
CH
D000328:Adult; D000368:Aged; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008875:Middle Aged; D011379:Prognosis; D012008:Recurrence; D012307:Risk Factors; D015996:Survival Rate; D015898:Tomography Scanners, X-Ray Computed; D014055:Tomography, Emission-Computed / Q000379:methods*; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*
D019788:Fluorodeoxyglucose F18