• Mathias Boughanim, Sophie Leboulleux, Annie Rey, Chi Tuan Pham, Yaelle Zafrani, Pierre Duvillard, Jean Lumbroso, Christine Haie-Meder, Martin Schlumberger, and Philippe Morice.
• Department of Surgery, Institut Gustave Roussy, and University Paris Sud, Villejuif, France.
• J. Clin. Oncol. 2008 May 20; 26 (15): 2558-61.

PurposeHistologic results of complete para-aortic lymphadenectomy were studied in patients treated for stage IB2/II cervical carcinoma who had no para-aortic uptake on [(18)F]fluorodeoxyglucose positron emission tomography combined with integrated computed tomography (FDG-PET/CT).Patients And MethodsPatients were treated between 2004 and 2006 for stage IB2/II cervical cancer. Magnetic resonance imaging of the abdomen and pelvis and FDG-PET/CT were initially performed. Patients with no para-aortic abnormalities were treated with external pelvic radiation therapy and concomitant chemotherapy followed by utero-vaginal brachytherapy. Para-aortic lymphadenectomy was then performed. FDG-PET/CT images were reviewed by two nuclear medicine specialists.ResultsThirty-eight patients were studied. Three patients had histologically proven para-aortic involvement (metastatic nodes with capsular rupture in the para-aortic area), leading to a negative predictive value of 92% for para-aortic nodal involvement.ConclusionIn this study, three of 38 patients with no para-aortic uptake on [(18)F]FDG-PET/CT imaging had histologically proven para-aortic node involvement. PET/CT imaging without histologic examination of the para-aortic area used to determine radiation therapy fields in stage IB2/II cervical cancer would overlook 8% of patients with histologic para-aortic nodal involvement.

38 keywords...

hide…