Positron Emission Tomography for Evaluating Para-aortic Nodal Metastasis in Locally Advanced Cervical Cancer Before Surgical Staging: A Surgicopathologic Study

Rose, Peter G.; Adler, Lee P.; Rodriguez, Michael J.; Faulhaber, Peter; Abdul‐Karim, Fadi W.; Miraldi, Floro

doi:10.1200/jco.1999.17.1.41

Cited by 327 publications

(152 citation statements)

References 18 publications

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“…Imaging with FDG-PET relies on physiologic processes rather than on the anatomic changes detected by conventional imaging techniques. 1,[3][4][5] A limited number of surgical staging studies have been performed in patients with carcinoma of the cervix and have indicated that FDG-PET has high sensitivity and specificity in detecting lymph node metastases. 5,55 The status of the pelvic, paraaortic, and supraclavicular lymph nodes, as determined by radiologic imaging studies, is not considered part of the clinical staging system.…”

Section: Petmentioning

confidence: 99%

“…1,[3][4][5] A limited number of surgical staging studies have been performed in patients with carcinoma of the cervix and have indicated that FDG-PET has high sensitivity and specificity in detecting lymph node metastases. 5,55 The status of the pelvic, paraaortic, and supraclavicular lymph nodes, as determined by radiologic imaging studies, is not considered part of the clinical staging system. An analysis of prognostic variables in 626 patients enrolled in clinical trials by the Gynecologic Oncology Group (GOG) revealed that in patients with Stage I-IVA cervical cancer who underwent surgical staging, the most significant prognostic factor was the status of the paraaortic lymph nodes; the second most significant prognostic factor was tumor size Ն 10 cm (relative risk, 3.9).…”

Section: Petmentioning

confidence: 99%

“…Positron emission tomography (PET), in conjunction with 2-[fluorine-1]fluoro-2-deoxy-D-glucose (FDG), has been used in cervical cancer staging and follow-up, [1][2][3][4][5] and it has been valuable in accurately assessing lymph node and distant metastases. 6 Newer, copper-labeled tracers also are expanding the range of uses of PET.…”

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Imaging in cervical cancer

Follen

Levenback

Iyer

et al. 2003

Cancer

125

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Section: Petmentioning

confidence: 99%

Section: Petmentioning

confidence: 99%

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Imaging in cervical cancer

Follen

Levenback

Iyer

et al. 2003

Cancer

125

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“…6 Positron emission tomography presents a high sensitivity and specificity in detecting paraaortic lymph node metastases. 7 Magnetic resonance and trans-rectal ultrasound has good accuracy describing local and regional invasion. 8 The exenteration was first defined by Brunschwig in 1948.…”

Section: Discussionmentioning

confidence: 99%

Total Infralevatorian Exenteration with Vulvectomy as Salvage Therapy in a Recurrent Irradiated Cervical Cancer with Pelvic Sidewall Involvement

Bécsi¹,

Szabó²,

Kiss³

et al. 2017

Journal of Interdisciplinary Medicine

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Despite the available effective screening techniques, cervical cancer is the most common genital malignancy in Romania. In patients with isolated pelvic recurrence after radiotherapy, exenteration represents the only chance for curative treatment. We present the case of a 45-year-old patient with a massive pelvic tumour causing intensive, poorly controlled vaginal bleeding, bilateral hydronephrosis and chronic renal failure. She underwent total infralevatorian exenteration with vulvectomy. Postoperative recovery was uneventful, and she presented a good evolution in the two months following surgery. We consider pelvic exenteration as the last treatment option to cure irradiated pelvic tumour recurrences. CASE REPORTWe present the case of a 45-year-old patient who was diagnosed with stage IIB squamous cervical carcinoma, complaining of atypical vaginal bleeding. She was referred to chemo-radiotherapy with curative intent. After five years she relapsed, complaining of lower abdominal pain and vaginal bleeding. Transrectal ultrasound (Figure 1) and magnetic resonance scan revealed a tumor of 8 × 4 cm, invading the parametrium bilaterally, the urinary bladder, the rectum, vagina, distal urethra, and the right internal iliac vessels. No distant metastases were described. The patient developed bilateral hydronephrosis with a nonfunctional right kidney. In September 2016, the patient had been admitted for intensive vaginal bleeding in order to attempt hemostasis and for blood transfusions.

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“…In recent years, many reports demonstrated the clinical usefulness provided by whole-body 18 F-fluorodeoxyglucose positron emission tomography (wb- 18 FDG PET) as well as by pelvic magnetic resonance imaging (pMRI), respectively, in the initial assessment of uterine cancers [4,5,10,11,12,13,14]. The purpose of this paper was to assess the appropriateness of wb 18 FDG PET plus pMRI in the pre-treatment staging of primary cervical cancers on the basis of the TNM classification.…”

Section: Introductionmentioning

confidence: 99%

Whole-body 18FDG PET plus pelvic MRI in the pre-treatment assessment of cervical cancers: an alternative to the FIGO clinical staging

Belhocine

2004

Gynecol Surg

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Growing evidence indicates that whole-body 18 F-fluorodeoxyglucose positron emission tomography (wb-18 FDG PET) plus pelvic magnetic resonance imaging (pMRI) may significantly improve the pre-treatment staging of primary cervical cancers. Such a combined protocol provides complementary insights into primary tumour delineation, loco-regional involvement and distant spread. As such, pMRI appears particularly reliable for the accurate measurement of tumour size, the detection of parametrial invasion and, even more so, for its exclusion. So far, wb-18 FDG PET yields unique information about extra-pelvic nodal and visceral tumour status. Of note, however, is the limitation of both imaging techniques for the detection of microscopic pelvic lymph node metastases, especially in early stage disease. Promising data also highlight the prognostic value of 18 FDG uptake as a marker of disease aggressiveness and of tumour resistance to treatment. The recent development of combined PET-CT scans as well as the validation of the sentinel node concept in gynaecological malignancies may grant new perspectives for optimal management of cervical cancers in the pre-treatment setting.

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Positron Emission Tomography for Evaluating Para-aortic Nodal Metastasis in Locally Advanced Cervical Cancer Before Surgical Staging: A Surgicopathologic Study

Abstract: Cervical cancers have a high avidity for FDG. The use of PET-FDG scanning accurately predicts both the presence and absence of pelvic and para-aortic nodal metastatic disease.

Cited by 327 publications

References 18 publications

Imaging in cervical cancer

Imaging in cervical cancer

Total Infralevatorian Exenteration with Vulvectomy as Salvage Therapy in a Recurrent Irradiated Cervical Cancer with Pelvic Sidewall Involvement

Whole-body 18FDG PET plus pelvic MRI in the pre-treatment assessment of cervical cancers: an alternative to the FIGO clinical staging

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