title: Role of [18F]fluoro-2-deoxy-D-glucose positron emission tomography in re-recurrent cervical cancer.
abstract: 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.
authors.affiliation: Departments of Obstetrics and Gynecology, Nuclear Medicine, Diagnostic Radiology, and Radiation Oncology, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors.forename: C-T
authors.initials: CT
authors.lastname: Lin
authors.forename: T-C
authors.initials: TC
authors.lastname: Yen
authors.forename: T-C
authors.initials: TC
authors.lastname: Chang
authors.forename: K-K
authors.initials: KK
authors.lastname: Ng
authors.forename: C-S
authors.initials: CS
authors.lastname: Tsai
authors.forename: K-C
authors.initials: KC
authors.lastname: Ho
authors.forename: C-H
authors.initials: CH
authors.lastname: Lai
mesh_terms: 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*
chemical_list: D019788:Fluorodeoxyglucose F18