title: Selection of patients with advanced-stage cervical cancer for para-aortic lymphadenectomy in the era of PET/CT.
abstract: BACKGROUND
  The aim of this study was to report the false-negative rate of positron-emission tomography (PET) /Computed Tomography (CT) for para-aortic (PA) lymph node (LN) metastasis and to examine if PA lymphadenectomy could be omitted when PET/CT of the pelvic area is negative.
  
  
  METHODS
  Patients without evidence of extrapelvic disease on preoperative imaging or in the PA area were included. Each patient underwent a laparoscopic PA lymphadenectomy.
  
  
  RESULTS
  A total of 61 patients were included. Seven patients (11%) had PALN metastasis. The false-negative rate of PET/CT was 11%. When PET/CT was positive for pelvic nodes, the risk for PA metastasis was 18% versus 8% when PET/CT was negative in the pelvic area (p=0.24).
  
  
  CONCLUSIONS
  The apparent low sensitivity of the PET/CT does not make it a relevant alternative to surgical LN staging when no uptake is visualized in the PA area. However, for patients in whom PET/CT is negative in the pelvic area, the risk of metastasis in the PA area is low.
authors.affiliation: Department of Gynecology and Obstetrics, Bichat Hospital, AP-HP, 46 rue Henri Huchard, 75018 Paris, France. martin.koskas@wanadoo.fr
authors.forename: Anne-Laure
authors.initials: AL
authors.lastname: Margulies
authors.forename: Alexandre
authors.initials: A
authors.lastname: Peres
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Barranger
authors.forename: Isabelle
authors.initials: I
authors.lastname: Perreti
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Brouland
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Toubet
authors.forename: Laure-Elise
authors.initials: LE
authors.lastname: Sarda-Mantel
authors.forename: Anne
authors.initials: A
authors.lastname: Thoury
authors.forename: Carmen
authors.initials: C
authors.lastname: Chis
authors.forename: Françoise
authors.initials: F
authors.lastname: Walker
authors.forename: Dominique
authors.initials: D
authors.lastname: Luton
authors.forename: Yann
authors.initials: Y
authors.lastname: Delpech
authors.forename: Martin
authors.initials: M
authors.lastname: Koskas
mesh_terms: D000328:Adult; D000368:Aged; D001011:Aorta / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology / Q000601:surgery; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging / Q000473:pathology; D008875:Middle Aged; D064847:Multimodal Imaging; D009367:Neoplasm Staging; D010388:Pelvis / Q000473:pathology / Q000601:surgery; D049268:Positron-Emission Tomography; D015996:Survival Rate; D014057:Tomography, X-Ray Computed; D002583:Uterine Cervical Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*