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Added value of para-aortic surgical staging compared to 18F-FDG PET/CT on the external beam radiation field for patients with locally advanced cervical cancer: An ONCO-GF study.
De Cuypere, Marjolein; Lovinfosse, Pierre; Goffin, Frédéric; Gennigens, Christine; Rovira, Ramon; Duch, Joan; Fastrez, Maxime; Gebhart, Géraldine; Squifflet, Jean Luc; Luyckx, Mathieu; Charaf, Gabriel; Crener, Kurt; Buxant, Frédéric; Bucella, Dario; Jouret, Mathieu; Hustinx, Roland; Kridelka, Frédéric.
Afiliación
  • De Cuypere M; Department of Obstetrics and Gynecology, University of Liège, Belgium. Electronic address: mdecuypere@chuliege.be.
  • Lovinfosse P; Department of Nuclear Medecine, University of Liège, Belgium.
  • Goffin F; Department of Obstetrics and Gynecology, University of Liège, Belgium.
  • Gennigens C; Department of Medical Oncology, University of Liège, Belgium.
  • Rovira R; Department of Gynecology Oncology and Laparoscopy, Hospital de la Santa Creu i Sant Pau of Barcelona, Spain.
  • Duch J; Department of Nuclear Medecine, Hospital de la Santa Creu i Sant Pau of Barcelona, Spain.
  • Fastrez M; Department of Gynecology, St Pierre University Hospital, Free University of Brussels, Belgium.
  • Gebhart G; Department of Nuclear Medecine, Institut Jules Bordet, Free University of Brussels, Belgium.
  • Squifflet JL; Department of Gynecology, Saint Luc Academic Hospital, Catholic University of Louvain, Brussels, Belgium.
  • Luyckx M; Department of Gynecology, Saint Luc Academic Hospital, Catholic University of Louvain, Brussels, Belgium.
  • Charaf G; Department of Obstetrics and Gynecology, University Ambroise Paré of Mons, Belgium.
  • Crener K; Department of Obstetrics and Gynecology, University Ambroise Paré of Mons, Belgium.
  • Buxant F; Department of Obstetrics and Gynecology, Iris South Hospital, Brussels, Belgium.
  • Bucella D; Department of Nuclear Medecine, Iris South Hospital, Brussels, Belgium.
  • Jouret M; Department of Obstetrics and Gynecology, CHwapi, Tournai, Belgium.
  • Hustinx R; Department of Nuclear Medecine, University of Liège, Belgium.
  • Kridelka F; Department of Obstetrics and Gynecology, University of Liège, Belgium.
Eur J Surg Oncol ; 46(5): 883-887, 2020 05.
Article en En | MEDLINE | ID: mdl-31784203
OBJECTIVE: Extended field chemoradiation is recommended for patients with locally advanced cervical cancer (LACC) and para-aortic lymph node (PALN) metastases. The radiation planning may be based on PET/CT while others recommend to rely on surgical staging. We report the rate of patients for whom the radiation field defined on PET/CT was modified by the histological PALN status. METHODS: Between March 2010 and December 2016, 168 consecutive patients with LACC underwent a pre-therapeutic PET/CT and PALN dissection. The data were reviewed retrospectively. The diagnostic performance of the PET/CT for definition of PALN status was calculated. We determined the percentage of patients for whom PALN dissection altered the external beam radiotherapy (EBRT) field defined on the PET/CT basis. RESULTS: Of 151 patients with negative PALNs on PET/CT, 26 had histological PALN metastases. Of 17 patients with positive PALNs on PET/CT, 9 were negative on histology of which 7 were located in the common iliac region. Sensitivity, specificity, positive and negative predictive value of PET/CT were 23.5, 93.3, 47.1 and 82.8% respectively. In total, 35 out of 168 patients underwent EBRT - field adaptation (pelvic vs extended field). The rate of radiation field modification (27,7%) was particularly high in the subgroup of patients with metastatic pelvic lymph nodes (PLNs) on PET/CT. CONCLUSION: Para-aortic surgical staging contributes significantly to individualize the radiation treatment of patients with LACC, particularly for those with positive PLNs at PET/CT. Indication of surgical staging deserves particular attention when the PET/CT suggests positive LNs in the common iliac region.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Carcinoma de Células Escamosas / Adenocarcinoma / Neoplasias del Cuello Uterino / Quimioradioterapia / Tomografía Computarizada por Tomografía de Emisión de Positrones / Escisión del Ganglio Linfático / Ganglios Linfáticos Tipo de estudio: Observational_studies / Risk_factors_studies Límite: Adult / Aged / Aged80 / Female / Humans / Middle aged Idioma: En Revista: Eur J Surg Oncol Asunto de la revista: NEOPLASIAS Año: 2020 Tipo del documento: Article Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Carcinoma de Células Escamosas / Adenocarcinoma / Neoplasias del Cuello Uterino / Quimioradioterapia / Tomografía Computarizada por Tomografía de Emisión de Positrones / Escisión del Ganglio Linfático / Ganglios Linfáticos Tipo de estudio: Observational_studies / Risk_factors_studies Límite: Adult / Aged / Aged80 / Female / Humans / Middle aged Idioma: En Revista: Eur J Surg Oncol Asunto de la revista: NEOPLASIAS Año: 2020 Tipo del documento: Article Pais de publicación: Reino Unido