title: Maximum standardized lymph node uptake value could be an important predictor of recurrence and survival in patients with cervical cancer.
abstract: OBJECTIVE
  To investigate prognostic values of maximum standardized lymph node (LN) uptake (SUVmax), minimum apparent LN diffusion coefficient (ADCmin), and LN short-axis length in women with cervical cancer.
  
  
  METHODS
  Retrospective review of diffusion-weighted magnetic resonance imaging (DWI) and positron emission tomography/computed tomography (PET/CT) of LN confined to the pelvis in 80 cervical cancer patients before undergoing radiotherapy (RT) with or without concurrent chemotherapy. Optimal cut-off values for disease-free survival (DFS) and overall survival (OS) were determined by receiver operating characteristic (ROC) curve analysis. We used ROC curve analyses to evaluate whether LN SUVmax, LN ADCmin and LN short-axis length predicted risk of recurrence or survival.
  
  
  RESULTS
  Median DFS and OS for all patients were 18.97 and 22.28 months, respectively. DFS and OS rates of patients with high LN SUVmax was significantly lower than those of patients exhibiting low LN SUVmax (P=0.003 and P=0.019). Patients with low LN ADCmin had poorer DFS and OS than those with high LN ADCmin (P=0.033 and P=0.005). DFS for patients exhibiting longer LN short-axis length was significantly lower than those of patients exhibiting shorter LN short-axis length (P=0.018). Multivariate analyses indicated that high LN SUVmax was an independent predictor for both DFS and OS (P=0.0231 and P=0.0146).
  
  
  CONCLUSIONS
  LN SUVmax could be an important predictor of recurrence and survival in patients with cervical cancer confined to the pelvis.
authors.affiliation: Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan. Electronic address: k-nakamu@cc.okayama-u.ac.jp.
authors.forename: Keiichiro
authors.initials: K
authors.lastname: Nakamura
authors.affiliation: Department of Medical Radiotechnology, Okayama University Graduate School of Health Sciences, Okayama, Japan.
authors.forename: Ikuo
authors.initials: I
authors.lastname: Joja
authors.affiliation: Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nagasaka
authors.affiliation: Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
authors.forename: Tomoko
authors.initials: T
authors.lastname: Haruma
authors.affiliation: Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Hiramatsu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging / Q000401:mortality / Q000473:pathology*; D038524:Diffusion Magnetic Resonance Imaging; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000473:pathology*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging / Q000401:mortality / Q000473:pathology*; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011379:Prognosis; D011877:Radionuclide Imaging; D012189:Retrospective Studies; D015996:Survival Rate; D002583:Uterine Cervical Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality / Q000473:pathology*
keywords: Cervical cancer; Maximum standardized lymph node uptake; Metastatic lymph node; Recurrence and survival