title: Histologic results of para-aortic lymphadenectomy in patients treated for stage IB2/II cervical cancer with negative [18F]fluorodeoxyglucose positron emission tomography scans in the para-aortic area.
abstract: OBJECTIVE
  Histologic results of complete para-aortic lymphadenectomy were studied in patients treated for stage IB2/II cervical carcinoma who had no para-aortic uptake on [(18)F]fluorodeoxyglucose positron emission tomography combined with integrated computed tomography (FDG-PET/CT).
  
  
  METHODS
  Patients were treated between 2004 and 2006 for stage IB2/II cervical cancer. Magnetic resonance imaging of the abdomen and pelvis and FDG-PET/CT were initially performed. Patients with no para-aortic abnormalities were treated with external pelvic radiation therapy and concomitant chemotherapy followed by utero-vaginal brachytherapy. Para-aortic lymphadenectomy was then performed. FDG-PET/CT images were reviewed by two nuclear medicine specialists.
  
  
  RESULTS
  Thirty-eight patients were studied. Three patients had histologically proven para-aortic involvement (metastatic nodes with capsular rupture in the para-aortic area), leading to a negative predictive value of 92% for para-aortic nodal involvement.
  
  
  CONCLUSIONS
  In this study, three of 38 patients with no para-aortic uptake on [(18)F]FDG-PET/CT imaging had histologically proven para-aortic node involvement. PET/CT imaging without histologic examination of the para-aortic area used to determine radiation therapy fields in stage IB2/II cervical cancer would overlook 8% of patients with histologic para-aortic nodal involvement.
authors.affiliation: Department of Surgery, Institut Gustave Roussy, and University Paris Sud, Villejuif, France.
authors.forename: Mathias
authors.initials: M
authors.lastname: Boughanim
authors.forename: Sophie
authors.initials: S
authors.lastname: Leboulleux
authors.forename: Annie
authors.initials: A
authors.lastname: Rey
authors.forename: Chi Tuan
authors.initials: CT
authors.lastname: Pham
authors.forename: Yaelle
authors.initials: Y
authors.lastname: Zafrani
authors.forename: Pierre
authors.initials: P
authors.lastname: Duvillard
authors.forename: Jean
authors.initials: J
authors.lastname: Lumbroso
authors.forename: Christine
authors.initials: C
authors.lastname: Haie-Meder
authors.forename: Martin
authors.initials: M
authors.lastname: Schlumberger
authors.forename: Philippe
authors.initials: P
authors.lastname: Morice
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D000328:Adult; D000368:Aged; D018288:Carcinoma, Small Cell / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000000981:diagnostic imaging* / Q000473:pathology; D008207:Lymphatic Metastasis; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009367:Neoplasm Staging; D010220:Para-Aortic Bodies / Q000000981:diagnostic imaging* / Q000473:pathology; D010386:Pelvic Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology; D049268:Positron-Emission Tomography; D011379:Prognosis; D019275:Radiopharmaceuticals; D015996:Survival Rate; D014057:Tomography, X-Ray Computed; D002583:Uterine Cervical Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18