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Comparison of Positron Emission Tomography Scanning and Sentinel Node Biopsy in the Detection of Inguinal Node Metastases in Patients With Anal Cancer

Journal Article · · International Journal of Radiation Oncology, Biology and Physics
 [1]; ;  [2]; ;  [3]; ;  [4]; ;  [5];  [4];  [1];  [6]
  1. Department of Surgery, University of Turin (Italy)
  2. Department of Nuclear Medicine, University of Turin (Italy)
  3. Department of Anatomo-Pathology, University of Turin (Italy)
  4. Department of Radiotherapy, University of Turin (Italy)
  5. Oncological Centre for Gastrointestinal Neoplasms, University of Turin (Italy) and PET Center IRMET, Turin (Italy)
  6. Surgical and Oncological Department, University of Turin (Italy)

Background: Inguinal lymph node metastases in patients with anal cancer are an independent prognostic factor for local failure and overall mortality. Inguinal lymph node status can be adequately assessed with sentinel node biopsy, and the radiotherapy strategy can subsequently be changed. We compared this technique vs. dedicated 18F-fluorodeoxyglucose positron emission tomography (PET) to determine which was the better tool for staging inguinal lymph nodes. Methods and Materials: In our department, 27 patients (9 men and 18 women) underwent both inguinal sentinel node biopsy and PET-CT. PET-CT was performed before treatment and then at 1 and 3 months after treatment. Results: PET-CT scans detected no inguinal metastases in 20 of 27 patients and metastases in the remaining 7. Histologic analysis of the sentinel lymph node detected metastases in only three patients (four PET-CT false positives). HIV status was not found to influence the results. None of the patients negative at sentinel node biopsy developed metastases during the follow-up period. PET-CT had a sensitivity of 100%, with a negative predictive value of 100%. Owing to the high number of false positives, PET-CT specificity was 83%, and positive predictive value was 43%. Conclusions: In this series of patients with anal cancer, inguinal sentinel node biopsy was superior to PET-CT for staging inguinal lymph nodes.

OSTI ID:
21372242
Journal Information:
International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 1 Vol. 77; ISSN IOBPD3; ISSN 0360-3016
Country of Publication:
United States
Language:
English