Interest of para-aortic lymphadenectomy for locally advanced cervical cancer in the era of PET scanning.
Eur J Obstet Gynecol Reprod Biol
; 272: 234-239, 2022 May.
Article
em En
| MEDLINE
| ID: mdl-35397374
ABSTRACT
BACKGROUND AND OBJECTIVES:
Treatment of locally advanced cervical cancer (LACC) involves pelvic chemoradiotherapy, using an extended field in the case of para-aortic involvement. 18-Fluoro-D-glucose positron emission tomography combined with computer tomography (PET-CT) is an accurate method for the detection of metastatic nodes. The objective of this study was to evaluate the performance of PET-CT for lymph node staging of LACC.METHODS:
This bicentric retrospective study included patients with LACC who had a PET-CT scan followed by para-aortic lymphadenectomy between January 2015 and December 2019. Based on pathological findings, sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV) and false-negative (FN) rates of PET-CT for para-aortic node involvement were evaluated.RESULTS:
Seventy-one patients who had undergone laparoscopic lymphadenectomy were included in this study. The intraoperative complication rate was 2.8%. Sensitivity, specificity, NPV and PPV for PET-CT were 55% [95% confidence interval (CI) 44.6-67.1], 84% (95% CI 75-92), 93% (95% CI 87-99) and 33% (95% CI 22-44), respectively. FN rates in the case of negative or positive pelvic PET-CT were 5.7% and 9.5%, respectively.CONCLUSIONS:
Para-aortic lymphadenectomy is recommended for lymph node staging in the case of negative para-aortic PET-CT. In view of the low FN rate of PET-CT, surgical staging should be discussed regardless of pelvic status if the patient presents high surgical risk, or if this delays the commencement of chemoradiotherapy.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Neoplasias do Colo do Útero
Tipo de estudo:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Female
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Humans
Idioma:
En
Revista:
Eur J Obstet Gynecol Reprod Biol
Ano de publicação:
2022
Tipo de documento:
Article
País de afiliação:
França