FDG-PET can predict survival of patients with cervical cancer
The location and extent of lymph node metastases demonstrated on FDG-PET may indicate the survival odds in patients with late-stage cervical cancer, according to researchers in St. Louis.
Investigators differentiated patients with stage IIIB cervical carcinoma: · patients with no lymph node metastases had a 68% chance of a three-year progression-free survival · with pelvic lymph node metastases, the odds dropped to 57% · pelvic and para-aortic lymph node metastases decreased the rate to 33% · patients with pelvic, para-aortic, and supraclavicular lymph node metastases had zero chance for a three-year progression-free survival
The study included 178 consecutive patients diagnosed with cervical cancer who were evaluated with whole-body FDG-PET before treatment. Among them, 40 patients had stage IIIB disease. Treatment included external-beam radiation, brachytherapy, and cisplatin chemotherapy for a total of six cycles.
The chances of survival worsened when positive lymph nodes were found farther away from the cervix, said coauthor Dr. Anurag K. Singh of the radiation oncology department at Washington University School of Medicine?s Siteman Cancer Center.
The results were presented in October at the American Society for Therapeutic Radiology and Oncology?s annual meeting in New Orleans.
It is now possible for researchers to use these findings to design prospective studies that tailor the aggressiveness of local and systemic therapy to the individual patient?s risk of distant and local disease, according to Singh.
FDG-PET scans significantly improve the detection rate for lymph node metastases, said senior author Dr. Perry W. Grigsby, a professor of radiation oncology at Siteman.
?FDG-PET is better than any other diagnostic imaging test,? he said.
