Integration of PET/CT into the preoperative evaluation of patients with early cervical cancer does not decrease the proportion of patients with positive lymph nodes found after surgery

Ofer Gemer, Ram Eitan*, Michael Gdalevich, Ala Mamanov, Benjamin Piura, Alex Rabinovich, Hanoch Levavi, Bozhena Saar-Ryss, Reuvit Halperin, Shahar Finci, Uzi Beller, Ilan Bruchim, Tally Levy, Inbar Ben-Shachar, Amichai Meirovitz, Alon Ben Arie, Ofer Lavie

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: The aim of this study was to evaluate whether preoperative positron emission tomography/computed tomography (PET/CT) in patients with early-stage cervical carcinoma reduced the proportion of patients with metastatic lymph nodes identified after surgery. Patients and Methods: This is a multicenter case-control study of 599 patients with early cervical cancer who underwent radical hysterectomy and pelvic lymphadenectomy at 1 of 10 gynecological oncology units in Israel. The patients were divided into 2 groups according to whether or not they underwent a preoperative PET/CT. The primary outcome was the proportion of patients with nodal involvement. The 2 groups were compared with regard to the clinical and histological variables. Results: Of the 599 patients who underwent surgery, 180 (36%) had preoperative PET/CT study. There were no significant differences between the PET/CT and control groups with regard to clinical and histological risk factors. The proportion of patients with involved nodes was similar in the control and PET/CT groups (20.8% vs 19%; P = 0.73) as well as the proportion of patients receiving adjuvant radiotherapy/chemoradiation (58.3% vs 55.1%; P = 0.55). Conclusions: Preoperative PET/CT in patients with early cervical cancer does not reduce proportion of patients with metastatic nodal involvement and the employment of multimodality treatment. Prospective clinical trials comparing management based on PET/CT findings are warranted.

Original languageEnglish
Pages (from-to)1461-1465
Number of pages5
JournalInternational Journal of Gynecological Cancer
Volume24
Issue number8
DOIs
StatePublished - 1 Oct 2014

Keywords

  • Cervical cancer
  • Lymph nodes
  • PET/CT
  • Surgery

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