Cem Onal1, Ozan C Guler2, Mehmet Reyhan3, Ali Fuat Yapar3. 1. Department of Radiation Oncology, Baskent University Faculty of Medicine, Adana, Turkey. Electronic address: hcemonal@hotmail.com. 2. Department of Radiation Oncology, Baskent University Faculty of Medicine, Adana, Turkey. 3. Department of Nuclear Medicine, Baskent University Faculty of Medicine, Ankara, Turkey.
Abstract
PURPOSE: To evaluate the prognostic significance of the maximum standardized uptake (SUVmax) value for pelvic lymph nodes in patients with cervical cancer and its impact on treatment response, disease control, and survival. METHODS: Ninety-three patients with pelvic or para-aortic metastasis detected by PET/CT and treated with definitive chemoradiotherapy were evaluated. The impact of pelvic lymph node SUVmax on prognostic factors and treatment outcomes was assessed. RESULTS: The size and SUVmax of pelvic lymph nodes were significantly correlated (r=0.859; p<0.001). Patients with pelvic and para-aortic lymph node metastases had significantly higher SUVmax values for both primary tumor (23.4±9.2 vs. 18.5±7.3; p=0.01) and pelvic lymph nodes (11.4±4.6 vs. 7.4±3.8; p=0.001). Patients with pelvic lymph node SUVmax≥7.5 had significantly higher primary tumor SUVmax, larger pelvic lymph nodes, higher rates of para-aortic lymph node metastasis, and lower post-therapy complete response rates. Overall survival (OS) and disease-free survival (DFS) rates were significantly higher in patients with SUVmax<7.5 compared to patients with SUVmax≥7.5. In a multivariate analysis, pelvic lymph node SUVmax and post-therapy metabolic response were significant prognostic factors for both OS and DFS for all patients, but no significant prognostic factors were found in pelvic lymph node metastasis only. CONCLUSIONS: Patients with highly FDG-avid pelvic lymph nodes have a higher risk of disease recurrence with worse survival. Identification of these patients may assist in the evaluation of the clinical benefits of additional treatments.
PURPOSE: To evaluate the prognostic significance of the maximum standardized uptake (SUVmax) value for pelvic lymph nodes in patients with cervical cancer and its impact on treatment response, disease control, and survival. METHODS: Ninety-three patients with pelvic or para-aortic metastasis detected by PET/CT and treated with definitive chemoradiotherapy were evaluated. The impact of pelvic lymph node SUVmax on prognostic factors and treatment outcomes was assessed. RESULTS: The size and SUVmax of pelvic lymph nodes were significantly correlated (r=0.859; p<0.001). Patients with pelvic and para-aortic lymph node metastases had significantly higher SUVmax values for both primary tumor (23.4±9.2 vs. 18.5±7.3; p=0.01) and pelvic lymph nodes (11.4±4.6 vs. 7.4±3.8; p=0.001). Patients with pelvic lymph node SUVmax≥7.5 had significantly higher primary tumor SUVmax, larger pelvic lymph nodes, higher rates of para-aortic lymph node metastasis, and lower post-therapy complete response rates. Overall survival (OS) and disease-free survival (DFS) rates were significantly higher in patients with SUVmax<7.5 compared to patients with SUVmax≥7.5. In a multivariate analysis, pelvic lymph node SUVmax and post-therapy metabolic response were significant prognostic factors for both OS and DFS for all patients, but no significant prognostic factors were found in pelvic lymph node metastasis only. CONCLUSIONS:Patients with highly FDG-avid pelvic lymph nodes have a higher risk of disease recurrence with worse survival. Identification of these patients may assist in the evaluation of the clinical benefits of additional treatments.
Authors: A Martinez; M Voglimacci; A Lusque; A Ducassou; L Gladieff; N Dupuis; M A Angeles; C Martinez; Y Tanguy Le Gac; E Chantalat; A Hitzel; F Courbon; G Ferron; E Gabiache Journal: Eur J Nucl Med Mol Imaging Date: 2020-01-08 Impact factor: 9.236
Authors: Jin Hwa Hong; Kyung Jin Min; Jae Kwan Lee; Kyeong A So; Un Suk Jung; Sungeun Kim; Jae Seon Eo Journal: Medicine (Baltimore) Date: 2016-03 Impact factor: 1.889