Article (Scientific journals)
Added value of para-aortic surgical staging compared to (18)F-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 et al.
2020In European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
Peer reviewed
 

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Keywords :
(18)F-FDG PET/CT; Locally advanced cervical cancer; Para-aortic lymph nodes; Surgical staging; oncology
Abstract :
[en] 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.
Disciplines :
Oncology
Author, co-author :
DE CUYPERE, Marjolein ;  Centre Hospitalier Universitaire de Liège - CHU > Département de gynécologie-obstétrique > Secteur oncologie
LOVINFOSSE, Pierre ;  Centre Hospitalier Universitaire de Liège - CHU > Département de Physique Médicale > Service médical de médecine nucléaire et imagerie onco
GOFFIN, Frédéric ;  Centre Hospitalier Universitaire de Liège - CHU > Département de gynécologie-obstétrique > Secteur gynécologie
Gennigens, Christine  ;  Université de Liège - ULiège > Département des sciences cliniques > Département des sciences cliniques
Rovira, Ramon
Duch, Joan
Fastrez, Maxime
Gebhart, Geraldine
Squifflet, Jean Luc
Luyckx, Mathieu
Charaf, Gabriel
Crener, Kurt
Buxant, Frederic
Bucella, Dario
Jouret, Mathieu
Hustinx, Roland  ;  Université de Liège - ULiège > Département des sciences cliniques > Médecine nucléaire
Kridelka, Frédéric ;  Université de Liège - ULiège > Département des sciences cliniques > Gynécologie-Obstétrique
More authors (7 more) Less
Language :
English
Title :
Added value of para-aortic surgical staging compared to (18)F-FDG PET/CT on the external beam radiation field for patients with locally advanced cervical cancer: An ONCO-GF study.
Publication date :
2020
Journal title :
European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
ISSN :
0748-7983
eISSN :
1532-2157
Peer reviewed :
Peer reviewed
Commentary :
Copyright (c) 2019 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.
Available on ORBi :
since 12 December 2019

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