title: Identification of prognostic factors in patients with cervical cancer and supraclavicular lymph node recurrence.
abstract: OBJECTIVE
  Patients with cervical cancer and supraclavicular lymph nodes (SLN) recurrence have a poor but heterogeneous prognosis. The aim of this study was to identify potential prognostic factors - including FDG-PET results - that may affect survival and treatment outcomes in patients with this group of patients.
  
  
  METHODS
  Between January 2001 and December 2008, we identified a total of 31 consecutive patients with cervical cancer who had evidence of SLN recurrence. All participants underwent FDG-PET. Survival was measured from the date of documented SLN recurrence. The latency period was defined as the length of time from the date of first diagnosis to the date of SLN recurrence.
  
  
  RESULTS
  The median follow-up time was 22.8 months (range: 4.7-105.1). The 3- and 5-year survival rates were 41% and 27.3%, respectively. Patients with intermediate SUV values (between 4.3 and 8) had a significantly better prognosis than subjects with both high (>8) or low (<4.3) SUV values (p=0.004). Latency period <2 years, SCC-Ag levels ≥ 4ng/mL, recurrence extend beyond SLN, and SUV of <4.3 >8 were significant adverse prognostic factors by multivariate analysis. The 3-year overall survival (OS) rate of patients carrying 0-1 adverse prognostic factors was 90% (low-risk group), while 3-year OS rates for intermediate-risk group (2 factors) and high-risk group (3-4 factors) were 30% and 0%, respectively (p=0.001).
  
  
  CONCLUSIONS
  Our results justify the use of PET (accurate extent of relapse and SUV) as a prognostic tool in patients with cervical cancer and SLN recurrence.
authors.affiliation: Department of Nuclear Medicine and Molecular Imaging Center, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Kung-Chu
authors.initials: KC
authors.lastname: Ho
authors.forename: Chun-Chieh
authors.initials: CC
authors.lastname: Wang
authors.forename: Jian-Tai
authors.initials: JT
authors.lastname: Qiu
authors.forename: Chyong-Huey
authors.initials: CH
authors.lastname: Lai
authors.forename: Ji-Hong
authors.initials: JH
authors.lastname: Hong
authors.forename: Yi-Ting
authors.initials: YT
authors.lastname: Huang
authors.forename: Kuan-Gen
authors.initials: KG
authors.lastname: Huang
authors.forename: Angel
authors.initials: A
authors.lastname: Chao
authors.forename: Gigin
authors.initials: G
authors.lastname: Lin
authors.forename: Tzu-Chen
authors.initials: TC
authors.lastname: Yen
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008207:Lymphatic Metastasis; D008875:Middle Aged; D049268:Positron-Emission Tomography; D011379:Prognosis; D012008:Recurrence; D015996:Survival Rate; D002583:Uterine Cervical Neoplasms / Q000401:mortality* / Q000473:pathology
chemical_list: D019788:Fluorodeoxyglucose F18