Standardized uptake value in para-aortic lymph nodes is a significant prognostic factor in patients with primary advanced squamous cervical cancer.
OBJECTIVE
We sought to identify prognostic factors-including positron emission tomography (PET) parameters-in patients with previously untreated squamous carcinoma of the uterine cervix and MRI- or CT-defined pelvic or para-aortic lymph node (PLN or PALN) metastasis.


METHODS
Patients with untreated squamous cell cervical cancer and PLN or PALN metastasis detected by CT/MRI were enrolled. FDG-PET scans were performed for primary staging. Prognostic variables were investigated by univariate and multivariate analyses. Five-year recurrence-free and 5-year overall survivals (RFS and OS) were evaluated using the Kaplan-Meier method.


RESULTS
A total of 70 patients [54 patients with International Federation of Gynecology and Obstetrics (FIGO) stage I or II, and 16 patients with stage III or IV] were eligible. Follow-up ranged from 26.1 to 71.6 months. In multivariate analysis, FIGO stage > or =III (5-year RFS, p = 0.008; 5-year OS, p = 0.008) was a significant prognostic factor for both RFS and OS. In addition, SUV(max) for PALN (dichotomized by 3.3) was significantly associated with OS (p = 0.012) and marginally with RFS (p = 0.078). The presence of SUV(max) > or = 3.3 at PALN or FIGO stage > or =III were significantly associated with both recurrence [5-year RFS; HR = 4.52, 95% confidence interval (CI) = 1.73-11.80] and death (5-year OS; HR = 6.04, 95% CI = 1.97-18.57).


CONCLUSIONS
SUV(max) > or = 3.3 for PALN and FIGO stage > or =III were significant adverse factors in patients with primary squamous cervical carcinoma and PLN or PALN metastasis detected by CT/MRI.
Yen
Tzu-Chen
TC
Molecular Imaging Center and Department of Nuclear Medicine, Chang Gung Memorial Hospital Linkou Medical Center, 5 Fu-Shin Street, Kueishan, Taoyuan, Taiwan. yen1110@adm.cgmh.org.tw
See
Lai-Chu
LC
Lai
Chyong-Huey
CH
Tsai
Chien-Sheng
CS
Chao
Angel
A
Hsueh
Swei
S
Hong
Ji-Hong
JH
Chang
Ting-Chang
TC
Ng
Koon-Kwan
KK
D000328:Adult; D000368:Aged; D001011:Aorta / Q000000981:diagnostic imaging; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging* / Q000401:mortality* / Q000556:secondary; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008207:Lymphatic Metastasis; D008875:Middle Aged; D011379:Prognosis; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D012680:Sensitivity and Specificity; D016019:Survival Analysis; D015996:Survival Rate; D013624:Taiwan / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000000981:diagnostic imaging* / Q000401:mortality*
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18