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

Anticancer Res. 2013 Jan;33(1):283-6.

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.

Patients and 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).

Conclusion: 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.

MeSH terms

  • 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*