title: Integration of PET/CT into the preoperative evaluation of patients with early cervical cancer does not decrease the proportion of patients with positive lymph nodes found after surgery.
abstract: OBJECTIVE
  The aim of this study was to evaluate whether preoperative positron emission tomography/computed tomography (PET/CT) in patients with early-stage cervical carcinoma reduced the proportion of patients with metastatic lymph nodes identified after surgery.
  
  
  METHODS
  This is a multicenter case-control study of 599 patients with early cervical cancer who underwent radical hysterectomy and pelvic lymphadenectomy at 1 of 10 gynecological oncology units in Israel. The patients were divided into 2 groups according to whether or not they underwent a preoperative PET/CT. The primary outcome was the proportion of patients with nodal involvement. The 2 groups were compared with regard to the clinical and histological variables.
  
  
  RESULTS
  Of the 599 patients who underwent surgery, 180 (36%) had preoperative PET/CT study. There were no significant differences between the PET/CT and control groups with regard to clinical and histological risk factors. The proportion of patients with involved nodes was similar in the control and PET/CT groups (20.8% vs 19%; P = 0.73) as well as the proportion of patients receiving adjuvant radiotherapy/chemoradiation (58.3% vs 55.1%; P = 0.55).
  
  
  CONCLUSIONS
  Preoperative PET/CT in patients with early cervical cancer does not reduce proportion of patients with metastatic nodal involvement and the employment of multimodality treatment. Prospective clinical trials comparing management based on PET/CT findings are warranted.
authors.affiliation: *Barzilai Medical Center, Ashkelon, Ben Gurion University of the Negev; †Rabin Medical Center, Petah Tikva, Tel Aviv University; ‡Soroka Medical Center, Beer Sheva, Ben Gurion University of the Negev; §Assaf Harofe Medical Center, Tzrifin, Tel Aviv University; ∥Shaare Zedek Medical Center, Jerusalem, Hebrew University; ¶Meir Medical Center, Kfar Saba, Tel Aviv University; #Wolfson Medical Center, Holon, Tel Aviv University; **Hadassah Medical Center-Mt Scopus, Jerusalem, Hebrew University; ††Sharett Institute of Oncology, Hadassah Medical Center, Jerusalem, Hebrew University; ‡‡Kaplan Medical Center, Rehovot, Hebrew University; and §§Carmel Medical Center, Haifa, Technion Institute, Israel.
authors.forename: Ofer
authors.initials: O
authors.lastname: Gemer
authors.forename: Ram
authors.initials: R
authors.lastname: Eitan
authors.forename: Michael
authors.initials: M
authors.lastname: Gdalevich
authors.forename: Ala
authors.initials: A
authors.lastname: Mamanov
authors.forename: Benjamin
authors.initials: B
authors.lastname: Piura
authors.forename: Alex
authors.initials: A
authors.lastname: Rabinovich
authors.forename: Hanoch
authors.initials: H
authors.lastname: Levavi
authors.forename: Bozhena
authors.initials: B
authors.lastname: Saar-Ryss
authors.forename: Reuvit
authors.initials: R
authors.lastname: Halperin
authors.forename: Shahar
authors.initials: S
authors.lastname: Finci
authors.forename: Uzi
authors.initials: U
authors.lastname: Beller
authors.forename: Ilan
authors.initials: I
authors.lastname: Bruchim
authors.forename: Tally
authors.initials: T
authors.lastname: Levy
authors.forename: Inbar
authors.initials: I
authors.lastname: Ben-Shachar
authors.forename: Amichai
authors.initials: A
authors.lastname: Meirovitz
authors.forename: Alon Ben
authors.initials: AB
authors.lastname: Arie
authors.forename: Ofer
authors.initials: O
authors.lastname: Lavie
mesh_terms: D000328:Adult; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods*; D009367:Neoplasm Staging / Q000379:methods; D049268:Positron-Emission Tomography; D057234:Preoperative Period; D011379:Prognosis; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D002583:Uterine Cervical Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*