Value of PET-CT in Avoiding Multimodality Therapy in Operable Cervical Cancer

Goyal, Bhupesh K.; Singh, Hariqbal; Kapur, Kanika; Duggal, Bhupinder S.; Jacob, MJ

doi:10.1111/igc.0b013e3181dcadeb

Cited by 14 publications

(6 citation statements)

References 16 publications

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“…They could optimally select their patients for surgery based on FDG PET/CT finding and could significantly reduce significant proportion of patients for multimodality treatment (from 30% to 12.5%, P < 0.01) associated with its morbidity. [13] Bentivegna et al .,[14] missed pelvic and para-aortic nodes in 4 of 16 patients (25%) with cervical cancer stage IB1 evaluated with FDG PET/CT. Sensitivity in this group could not be calculated technically as FDG PET scan was not positive in any of the patients.…”

Section: Resultsmentioning

confidence: 99%

Fluorodeoxyglucose positron emission tomography-computed tomography in evaluation of pelvic and para-aortic nodal involvement in early stage and operable cervical cancer: Comparison with surgicopathological findings

2011

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Introduction:Nodal metastases in cervical cancer have prognostic implications. Imaging is used as an adjunct to clinical staging for evaluation of nodal metastases. Fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) has an advantage of superior resolution of its CT component and detecting nodal disease based on increased glycolytic activity rather than node size. But there are limited studies describing its limitations in early stage cervical cancers.Objective:We have done meta-analysis with an objective to evaluate the efficacy of FDG PET/CT and its current clinical role in early stage and operable cervical cancer.Materials and Methods:Studies in which FDG PET/CT was performed before surgery in patients with early stage cervical cancers were included for analysis. PET findings were confirmed with histopathological diagnosis rather than clinical follow-up. FDG PET/CT showed lower sensitivity and clinically unacceptable negative predictive value in detecting nodal metastases in early stage cervical cancer and therefore, can not replace surgicopathological staging. False negative results in presence of microscopic disease and sub-centimeter diseased nodes are still the area of concern for metabolic imaging. However, these studies are single institutional and performed in a small group of patients. There is enough available evidence of clinical utility of FDG PET/CT in locally advanced cervical cancer. But these results can not be extrapolated for early stage disease.Conclusion:The current data suggest that FDG PET/CT is suboptimal in nodal staging in early stage cervical cancer.

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Section: Resultsmentioning

confidence: 99%

Fluorodeoxyglucose positron emission tomography-computed tomography in evaluation of pelvic and para-aortic nodal involvement in early stage and operable cervical cancer: Comparison with surgicopathological findings

2011

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“…En lo que refiere al impacto en la conducta clínica a seguir de acuerdo con el resultado del estudio, en los casos de los resultados obtenidos de pacientes con cáncer de cuello uterino, el 60% de los estudios realizados de-pacientes que van a recibir más de un tratamiento de 30% a 12,5%, lo que significa que más de 87% de las pacientes pueden evitar los efectos colaterales de la suma de tratamientos subóptimos (10,11) . No obstante, el PET/TC todavía no se ha incorporado en la evaluación prequirúrgica en nuestro medio.…”

Section: Resultsunclassified

Análisis de la aplicación clínica de la tomografía por emisión de positrones en el ejercicio de la ginecología oncológica en el Hospital de la Mujer

Nozar

Rossi

Barbajelata

et al. 2020

RMU

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El PET (Positron Emission Tomography) con 18-flúor-desoxi-glucosa (18FDG) como radiofármaco es una técnica diagnóstica de medicina nuclear no invasiva cuyas indicaciones fundamentalmente se vinculan con patologías oncológicas. Objetivo: valorar la indicación y el impacto del PET con 18FDG en la atención de mujeres con patología oncológica ginecológica. Estudio: descriptivo retrospectivo mediante la revisión de historias clínicas de las pacientes con cáncer ginecológico asistidas en el Hospital de la Mujer (HM), a las cuales se les realizó un PET con 18FDG en la evaluación diagnóstica o en el seguimiento en el período comprendido entre 1/1/2014 y 31/12/2017. Se analizaron un total de 68 pacientes en las cuales se realizaron 112 PET con 18FDG. En cuanto a la indicación, en los casos de cáncer de cuello (CC), la mayoría (51,5%) de los PET se realizaron ante la sospecha de recidiva; en el cáncer de mama (CM) en el control evolutivo, (44,6%); en los cánceres de endometrio (CE) ante la sospecha de recidiva, (50%); en los cánceres de ovario el 37,5% ante sospecha de recidiva e igual porcentaje en control evolutivo; en los cánceres de vulva (CV) en control postratamiento o sospecha de recidiva, (50% c/u). En cuanto al impacto en la conducta clínica, globalmente, en los casos CC, el 60% de los estudios realizados determinaron modificaciones en la conducta clínica; en los CM, 49%; en los CE, 43%; en los CO, 50%; en los CV, 50%. El PET con 18FDG es una técnica que se ha incorporado a la práctica clínica ginecológica y que requiere aún incorporar las pautas de su utilización.

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“…The subgroup of patients with microscopic nodal disease probably benefited from further therapy as their mean survival was 41 months, whereas those with CAT negative, but grossly bulky adenopathy at surgery had a mean survival of only 15 months. Because fluorodeoxyglucose-positron emission tomography (FDG-PET) imaging is more sensitive than CAT scanning for detecting metastatic disease [15], pretreatment screening with PET may allow exclusion of patients with occult para-aortic disease who would be less likely to benefit from adjuvant hysterectomy.…”

Section: Discussionmentioning

confidence: 99%

Chemoradiation with adjuvant hysterectomy for stage IB-2 cervical cancer: a 10-year experience

et al. 2011

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To review outcomes of patients with stage IB-2 cervical carcinoma treated with chemoradiation therapy (CRT) followed by total abdominal hysterectomy (TAH), common iliac and para-aortic lymphadenectomy (PAL). A retrospective review of patients with stage IB-2 cervical cancer treated with CRT followed by TAH/PAL from 1999 to 2009 was performed. Brachytherapy was limited to 1,500-1,800 cGy. Sixty-nine patients were identified. The mean age was 46.7 years, tumor diameter 5.4 cm, and all patients had complete clinical response to CRT. The mean follow-up was 61.7 months. There were no central pelvic relapses and two pelvic sidewall failures (97% pelvic control). The mean time to progression was 31.6 months, and 5-year disease-specific survival was 81%. Three (4.3%) patients developed symptomatic vaginal stenosis. CRT plus adjuvant hysterectomy for stage IB-2 cervical cancer resulted in excellent pelvic control and 5-year survival. Vaginal stenosis was rare.

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Value of PET-CT in Avoiding Multimodality Therapy in Operable Cervical Cancer

Abstract: Positron emission tomography combined with CT in the evaluation of operable cervical cancer can help in the optimal selection of patients for surgery such that multimodality treatment with its attendant increase in morbidity is avoided.

Cited by 14 publications

References 16 publications

Fluorodeoxyglucose positron emission tomography-computed tomography in evaluation of pelvic and para-aortic nodal involvement in early stage and operable cervical cancer: Comparison with surgicopathological findings

Fluorodeoxyglucose positron emission tomography-computed tomography in evaluation of pelvic and para-aortic nodal involvement in early stage and operable cervical cancer: Comparison with surgicopathological findings

Análisis de la aplicación clínica de la tomografía por emisión de positrones en el ejercicio de la ginecología oncológica en el Hospital de la Mujer

Chemoradiation with adjuvant hysterectomy for stage IB-2 cervical cancer: a 10-year experience

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