Pelvic Lymph Node Status Assessed by 18F-Fluorodeoxyglucose Positron Emission Tomography Predicts Low-Risk Group for Distant Recurrence in Locally Advanced Cervical Cancer: A Prospective Study

Journal Article · Tue Mar 01 00:00:00 EST 2011 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2009.11.031· OSTI ID:21491616

Kang, Sokbom ^[1]; Park, Jung-Yeol; Lim, Myung-Chul; Song, Yong-Joong; Park, Se-Hyun ^[1]; Kim, Seok-Ki ^[2]; Chung, Dae-Chul; Seo, Sang-Soo; Kim, Joo-Young; Park, Sang-Yoon ^[1]

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1. Center for Uterine Cancer, Research Institute and Hospital, National Cancer Center, Goyang (Korea, Republic of)
2. Center for Diagnostic Oncology, Research Institute and Hospital, National Cancer Center, Goyang (Korea, Republic of)

Purpose: To develop a prediction model to identify a low-risk group for distant recurrence in patients with locally advanced cervical cancer treated by concurrent chemoradiation. Methods and Materials: Prospectively, 62 patients with locally advanced cervical cancer were recruited as a training cohort. Clinical variables and parameters obtained from positron emission tomography (PET) and magnetic resonance imaging were analyzed by logistic regression. For the test set, 54 patients were recruited independently. To identify the low-risk group, negative likelihood ratio (LR) less than 0.2 was set to be a cutoff. Results: Among the training cohort, multivariate logistic analysis revealed that advanced International Federation of Gynecology and Obstetrics (FIGO) stage and a high serum squamous cancer cell (SCC) antigen level were significant risk factors (p = 0.015 and 0.025, respectively). Using the two parameters, criteria to determine a low-risk subset for distant recurrence were postulated: (1) FIGO Stage IIB or less and (2) pretreatment SCC < 2.4 (Model A). Positive pelvic node on PET completely predicted all cases with distant recurrence and thus was considered as another prediction model (Model B). In the test cohort, although Model A did not showed diagnostic performance, Model B completely predicted all cases with distant recurrence and showed a sensitivity of 100% with negative LR of 0. Across the training and test cohort (n = 116), the false negative rate was 0 (95% confidence interval 0%-7.6%). Conclusions: Positive pelvic node on PET is a useful marker in prediction of distant recurrence in patients with locally advanced cervical cancer who are treated with concurrent chemoradiation.

• OSTI ID: 21491616
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Vol. 79, Issue 3; Other Information: DOI: 10.1016/j.ijrobp.2009.11.031; PII: S0360-3016(09)03572-X; Copyright (c) 2011 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; ISSN 0360-3016
• Country of Publication: United States
• Language: English

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62 RADIOLOGY AND NUCLEAR MEDICINE
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MULTIVARIATE ANALYSIS
NEOPLASMS
NMR IMAGING
POSITRON COMPUTED TOMOGRAPHY
UROGENITAL SYSTEM DISEASES
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DIAGNOSTIC TECHNIQUES
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FLUORINE ISOTOPES
HOURS LIVING RADIOISOTOPES
ISOMERIC TRANSITION ISOTOPES
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LIGHT NUCLEI
LYMPHATIC SYSTEM
MATHEMATICS
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NANOSECONDS LIVING RADIOISOTOPES
NUCLEI
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