Ofer Gemer1, 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. 1. *Barzilai Medical Center, Ashkelon, Ben Gurion University of the Negev; †Rabin Medical Center, Petah Tikva, Tel Aviv University; ‡Soroka Medical Center, Beer Sheva, Ben Gurion University of the Negev; §Assaf Harofe Medical Center, Tzrifin, Tel Aviv University; ∥Shaare Zedek Medical Center, Jerusalem, Hebrew University; ¶Meir Medical Center, Kfar Saba, Tel Aviv University; #Wolfson Medical Center, Holon, Tel Aviv University; **Hadassah Medical Center-Mt Scopus, Jerusalem, Hebrew University; ††Sharett Institute of Oncology, Hadassah Medical Center, Jerusalem, Hebrew University; ‡‡Kaplan Medical Center, Rehovot, Hebrew University; and §§Carmel Medical Center, Haifa, Technion Institute, Israel.
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.
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.
Authors: Aida Steiner; Sara Narva; Irina Rinta-Kiikka; Sakari Hietanen; Johanna Hynninen; Johanna Virtanen Journal: Cancer Imaging Date: 2021-01-22 Impact factor: 3.909