Selection of patients with advanced-stage cervical cancer for para-aortic lymphadenectomy in the era of PET/CT

• Published in: Anticancer research Vol. 33; no. 1; pp. 283 - 286
• Main Authors: Margulies, Anne-Laure, Peres, Alexandre, Barranger, Emmanuel, Perreti, Isabelle, Brouland, Jean-François, Toubet, Elisabeth, Sarda-Mantel, Laure-Elise, Thoury, Anne, Chis, Carmen, Walker, Françoise, Luton, Dominique, Delpech, Yann, Koskas, Martin
• Format: Journal Article
• Language: English
• Published: Greece 01.01.2013
• Subjects: Adult; Aged; Aorta - pathology; Aorta - surgery; Female; Humans; Laparoscopy; Lymph Node Excision; Lymph Nodes - pathology; Lymph Nodes - surgery; Lymphatic Metastasis - diagnostic imaging; Lymphatic Metastasis - pathology; Middle Aged; Multimodal Imaging; Neoplasm Staging; Pelvis - pathology; Pelvis - surgery; Positron-Emission Tomography; Survival Rate; Tomography, X-Ray Computed; Uterine Cervical Neoplasms - diagnostic imaging; Uterine Cervical Neoplasms - pathology; Uterine Cervical Neoplasms - surgery
• ISSN: 1791-7530

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. Patients without evidence of extrapelvic disease on preoperative imaging or in the PA area were included. Each patient underwent a laparoscopic PA lymphadenectomy. 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). 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.