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.
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.
Boughanim
Mathias
M
Department of Surgery, Institut Gustave Roussy, and University Paris Sud, Villejuif, France.
Leboulleux
Sophie
S
Rey
Annie
A
Pham
Chi Tuan
CT
Zafrani
Yaelle
Y
Duvillard
Pierre
P
Lumbroso
Jean
J
Haie-Meder
Christine
C
Schlumberger
Martin
M
Morice
Philippe
P
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
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18