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Standardized uptake value in para-aortic lymph nodes is a significant prognostic factor in patients with primary advanced squamous cervical cancer

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

We sought to identify prognostic factors—including positron emission tomography (PET) parameters—in patients with previously untreated squamous carcinoma of the uterine cervix and MRI- or CT-defined pelvic or para-aortic lymph node (PLN or PALN) metastasis.

Materials and methods

Patients with untreated squamous cell cervical cancer and PLN or PALN metastasis detected by CT/MRI were enrolled. FDG-PET scans were performed for primary staging. Prognostic variables were investigated by univariate and multivariate analyses. Five-year recurrence-free and 5-year overall survivals (RFS and OS) were evaluated using the Kaplan–Meier method.

Results

A total of 70 patients [54 patients with International Federation of Gynecology and Obstetrics (FIGO) stage I or II, and 16 patients with stage III or IV] were eligible. Follow-up ranged from 26.1 to 71.6 months. In multivariate analysis, FIGO stage ≥III (5-year RFS, p = 0.008; 5-year OS, p = 0.008) was a significant prognostic factor for both RFS and OS. In addition, SUVmax for PALN (dichotomized by 3.3) was significantly associated with OS (p = 0.012) and marginally with RFS (p = 0.078). The presence of SUVmax ≥ 3.3 at PALN or FIGO stage ≥III were significantly associated with both recurrence [5-year RFS; HR = 4.52, 95% confidence interval (CI) = 1.73–11.80] and death (5-year OS; HR = 6.04, 95% CI = 1.97–18.57).

Conclusion

SUVmax ≥ 3.3 for PALN and FIGO stage ≥III were significant adverse factors in patients with primary squamous cervical carcinoma and PLN or PALN metastasis detected by CT/MRI.

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Acknowledgments

This research was supported by grants NSC 93-2314-B-182A-036 from the National Science Council-Taiwan and CMRPG 32023-II, CMRPG 32024-II, and CMRPD 32014 from the Chang Gung Memorial Hospital and University.

Conflict of interest statement

None declared.

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Authors and Affiliations

  1. Molecular Imaging Center and Department of Nuclear Medicine, Chang Gung Memorial Hospital Linkou Medical Center, 5 Fu-Shin St, Kueishan, Taoyuan, 333, Taiwan

    Tzu-Chen Yen

  2. Biostatistics Consulting Center, Department of Public Health, Chang Gung Memorial Hospital Linkou Medical Center, Taoyuan, Taiwan

    Lai-Chu See

  3. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital Linkou Medical Center, Taoyuan, Taiwan

    Chyong-Huey Lai, Angel Chao & Ting-Chang Chang

  4. Departments of Radiation Oncology, Chang Gung Memorial Hospital Linkou Medical Center, Taoyuan, Taiwan

    Chien-Sheng Tsai & Ji-Hong Hong

  5. Department of Pathology, Chang Gung Memorial Hospital Linkou Medical Center, Taoyuan, Taiwan

    Swei Hsueh

  6. Department of Medical Imaging & Intervention, Chang Gung Memorial Hospital Linkou Medical Center and Chang Gung University, Taoyuan, 333, Taiwan

    Koon-Kwan Ng

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  1. Tzu-Chen Yen
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  2. Lai-Chu See
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Correspondence to Koon-Kwan Ng.

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Yen, TC., See, LC., Lai, CH. et al. Standardized uptake value in para-aortic lymph nodes is a significant prognostic factor in patients with primary advanced squamous cervical cancer. Eur J Nucl Med Mol Imaging 35, 493–501 (2008). https://doi.org/10.1007/s00259-007-0612-1

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  • DOI: https://doi.org/10.1007/s00259-007-0612-1

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