title: Survival of Cervical Cancer Patients Presenting with Occult Supraclavicular Metastases Detected by FDG-Positron Emission Tomography/CT: Impact of Disease Extent and Treatment.
abstract: OBJECTIVE
  The study aimed to do the following: (1) describe progression free survival (PFS) and overall survival (OS) of women with cervical cancer presenting with occult supraclavicular lymph node (SCLN) metastases, identified by positron emission tomography CT (PET-CT) and (2) compare OS of patients with isolated SCLN metastases to that of patients with SCLN and extranodal metastatic disease.
  
  
  METHODS
  Patients were identified retrospectively. Treatment intent was abstracted. PFS and OS in the high-dose chemo-radiotherapy (RT), palliative RT, and supportive treatment groups, as well as OS of patients with SCLN metastases only vs. SCLN and extranodal metastases were calculated.
  
  
  RESULTS
  Fourteen patients received high-dose chemo-RT, 32 received palliative RT, and 6 received supportive care (n = 52). Median PFS was 3 months in high-dose chemo-RT group and 1 month in palliative RT (p = ns). Median OS was 12 months in high-dose chemo-RT group, 7 months in palliative RT group, and 2 months in palliative care group (p = 0.05). OS was significantly different between patients with isolated SCLN disease vs. SCLN and extranodal disease, that is, 10.5 vs. 3 months (p = 0.009, χ2 = 6.9).
  
  
  CONCLUSIONS
  In this limited analysis, median OS of cervical cancer patients with PET/CT-positive SCLN metastases was the longest when treated with high-dose chemo-RT. Patients with SCLN and extranodal metastases experienced significantly shorter OS, as compared to patients with SCLN only disease.
authors.affiliation: Department of Gynecology and Obstetrics, Loma Linda University School of Medicine, Loma Linda, CA, USA.
authors.forename: Yevgeniya J
authors.initials: YJ
authors.lastname: Ioffe
authors.forename: Leslie Stewart
authors.initials: LS
authors.lastname: Massad
authors.forename: Matthew A
authors.initials: MA
authors.lastname: Powell
authors.forename: Andrea R
authors.initials: AR
authors.lastname: Hagemann
authors.forename: David G
authors.initials: DG
authors.lastname: Mutch
authors.forename: Premal H
authors.initials: PH
authors.lastname: Thaker
authors.forename: Julie K
authors.initials: JK
authors.lastname: Schwarz
authors.forename: Perry W
authors.initials: PW
authors.lastname: Grigsby
mesh_terms: D000328:Adult; D000368:Aged; D059248:Chemoradiotherapy; D002968:Clavicle; D018572:Disease-Free Survival; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging* / Q000473:pathology; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000379:methods / Q000706:statistics & numerical data*; D000072078:Positron Emission Tomography Computed Tomography / Q000379:methods*; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality* / Q000473:pathology / Q000628:therapy
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: Advanced cervical cancer; Chemo-radiation; Palliative chemo-radiation