FDG-PET lymph node staging and survival of patients with FIGO stage IIIB cervical carcinoma

Singh, Anvita; Grigsby, P.W.; Dehdashti, Farrokh; Siegel, Barry A.

doi:10.1016/s0360-3016(02)03175-9

Cited by 7 publications

(11 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[28][29][30] The role of PET-CT to detect lymph nodal metastasis has been studied in various centers and the results are promising. [31][32][33][34][35] In a case of radical surgery, pathological assessment of lymph nodes will be possible. Alternatively, there may be a practice/capability for imaging-guided fine needle aspiration cytology.…”

Section: Commentmentioning

confidence: 99%

Revised FIGO staging for carcinoma of the cervix uteri

Bhatla

Berek

Fredes

et al. 2019

Intl J Gynecology & Obste

782

594

View full text Add to dashboard Cite

Objective To revise FIGO staging of carcinoma of the cervix uteri, allowing incorporation of imaging and/or pathological findings, and clinical assessment of tumor size and disease extent. Methods Review of literature and consensus view of the FIGO Gynecologic Oncology Committee and related societies and organizations. Results In stage I, revision of the definition of microinvasion and lesion size as follows. Stage IA: lateral extension measurement is removed; stage IB has three subgroups—stage IB1: invasive carcinomas ≥5 mm and <2 cm in greatest diameter; stage IB2: tumors 2–4 cm; stage IB3: tumors ≥4 cm. Imaging or pathology findings may be used to assess retroperitoneal lymph nodes; if metastatic, the case is assigned stage IIIC; if only pelvic lymph nodes, the case is assigned stage IIIC1; if para‐aortic nodes are involved, the case is assigned stage IIIC2. Notations ‘r’ and ‘p’ will indicate the method used to derive the stage—i.e., imaging or pathology, respectively—and should be recorded. Routine investigations and other methods (e.g., examination under anesthesia, cystoscopy, proctoscopy, etc.) are not mandatory and are to be recommended based on clinical findings and standard of care. Conclusion The revised cervical cancer staging is applicable to all resource levels. Data collection and publication will inform future revisions.

show abstract

Section: Commentmentioning

confidence: 99%

Revised FIGO staging for carcinoma of the cervix uteri

Bhatla

Berek

Fredes

et al. 2019

Intl J Gynecology & Obste

782

594

View full text Add to dashboard Cite

show abstract

“…(15) On the contrary, the recent studies have reported that positron emission tomography (PET or PET ⁄ CT), employing [ 18 F]-fluoro-2-deoxy-D-glucose (FDG), is more sensitive than CT or MRI for detection of metastatic lymph nodes in patients with cervical cancer. (16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33) Numerous studies have described the use of CT, MRI, and PET or PET ⁄ CT for detection of metastatic lymph nodes in patients with cervical cancer, but no studies have compared these three imaging modalities for those patients. Some previous studies have compared PET and MRI and suggested that PET is more accurate than MRI, but the statistical power of the comparisons was too low to assess the significance of this difference.…”

mentioning

confidence: 99%

Diagnostic performance of computer tomography, magnetic resonance imaging, and positron emission tomography or positron emission tomography/computer tomography for detection of metastatic lymph nodes in patients with cervical cancer: Meta‐analysis

Choi

Ju²,

Myung³

et al. 2010

Cancer Science

277

176

View full text Add to dashboard Cite

We performed a meta-analysis to compare diagnostic performances of computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET or PET/CT), for detection of metastatic lymph nodes in patients with cervical cancer. We searched MEDLINE (PubMed), EMBASE and the Cochrane Review database in December 2007. All articles were independently reviewed and selected by three evaluators. We estimated a summary receiver operating characteristic (sROC) curve. The area under the curve (AUC), Q*, and pooled weighted estimates of sensitivity and specificity for each modality by patient-based and region-or node-based data analyses and conducted pair-wise comparisons between modalities using the two-sample Z-test. Fortyone of 768 initially identified studies were included in the metaanalysis. In a patient-based data analysis, PET or PET/CT showed the highest pooled sensitivity (82%) and specificity (95%), while CT showed 50% and 92%; and MRI, 56% and 91%, respectively. The AUC (0.9641) and Q* (0.9106) of PET or PET/CT were significantly higher than those of MRI (AUC = 0.8270; Q* = 0.7599), both P < 0.001. In region-or node-based data analysis, sensitivities of CT (52%) and PET or PET/CT (54%) were higher than that of MRI (38%), P < 0.02 and P < 0.001, respectively, while specificities of MRI (97%) and PET or PET/CT (97%) were higher than that of CT (92%), both P < 0.001. The AUC and Q* showed no significant difference among CT, MRI, and PET or PET/CT. PET or PET/CT had an overall higher diagnostic performance than did CT or MRI in detecting metastatic lymph nodes in patients with cervical cancer. (Cancer Sci 2010; 101: 1471-1479 U terine cervical carcinoma is the second most common malignancy in women worldwide, and is the only major gynecologic malignancy that is staged clinically according to International Federation of Obstetrics and Gynecology (FIGO) recommendations.(1) However, clinical staging of cervical cancer is accurate in only 29% of patients. Undiagnosed lymph node metastases are a major problem (2)(3)(4)(5) because lymph node status is an independent prognostic factor for survival of patients with primary cervical cancer.(6-9) Although lymph node dissection before radiotherapy results in improved survival of patients with macroscopically enlarged pelvic and para-aortic lymph nodes, the routine pretreatment surgical staging is not recommended. Thus, an inaccurate evaluation of lymph node metastasis associated with uterine cervical carcinoma often leads to unsatisfactory treatment. (10)(11)(12)(13)(14) Computed tomography (CT) and magnetic resonance imaging (MRI) have been used to assess the metastatic lymph nodes of cervical cancer patients. A meta-analysis of studies evaluating these diagnostic methods concluded that these methods have only moderate sensitivity and specificity for detection of metastatic lymph nodes.(15) On the contrary, the recent studies have reported that positron emission tomography (PET or PET ⁄ CT), employing [18 F]-fluoro-2-deoxy-D-glucose (FDG), is more sensi...

show abstract

“…The incidence of paraaortic lymph node metastases increases with tumour stage (IB 6%; IIB 19%; IIIB 29%; V 30%) (Nibe et al 2003;Ahmed et al 2004). The Gynecologic Oncology Group identified paraaortic lymph node metastases and tumour size as the two most significant prognostic factors regarding survival (Singh et al 2003). Furthermore, lymph node metastases have major impact on the risk of local and distant cancer recurrence as well as disease-specific survival (Munkarah 2002).…”

Section: Introductionmentioning

confidence: 99%

“…If supraclavicular lymph nodes are positive, the survival rate is even worse (mean 10-12 months, maximum 17 months). Non-nodal distant metastatic sites are lung, liver and bone (Grigsby et al 1999;Singh et al 2003). Aggressive therapy is an option to control pelvic disease, but all patients finally develop distant metastases and will die from their disease.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Supraclavicular lymph node metastases of unknown origin: HPV-typing identifies the primary tumour

Kuemper

Burges²,

Hillemanns³

et al. 2009

European Journal of Cancer Care

View full text Add to dashboard Cite

Cancers of unknown primary origin (CUP) account for 0.5-10% of all malignancies. CUP patients with metastases have a median survival of approximately 6 months, despite therapy. Identification of the primary tumour site may offer the opportunity of a specific and more efficient treatment. The case of a 45-year-old woman with supraclavicular lymph node metastases of a squamous cell CUP is reported. A staging laparoscopy with multiple biopsies and a loop diathermy excision of the cervix were performed. Human papillomavirus (HPV)-testing in the tissues revealed the tumour cells as metastases of an occult cervical cancer. Primary platin-based chemotherapy combined with paclitaxel leads to a complete apparative remission. Twelve months later, staging positron emission tomography with 2-[18F]fluoro-2-deoxy-D-glucose in combination with computed tomography identified an isolated left renal lymph node metastasis. The patient received targeted radiation therapy, combined with cisplatin. To date, 19 months after diagnosis, she is doing well without any evidence of disease. The presented case report addresses the difficulties involving the identification of CUP. HPV-DNA is found in over 95% of cervical cancers. As the presented case illustrates, testing for this virus DNA in human tissues can be a useful diagnostic tool in patients with CUP where cervical cancer is the possible primary tumour.

show abstract

FDG-PET lymph node staging and survival of patients with FIGO stage IIIB cervical carcinoma

Cited by 7 publications

References 0 publications

Revised FIGO staging for carcinoma of the cervix uteri

Revised FIGO staging for carcinoma of the cervix uteri

Diagnostic performance of computer tomography, magnetic resonance imaging, and positron emission tomography or positron emission tomography/computer tomography for detection of metastatic lymph nodes in patients with cervical cancer: Meta‐analysis

Supraclavicular lymph node metastases of unknown origin: HPV-typing identifies the primary tumour

Contact Info

Product

Resources

About