Prognostic value of fluorodeoxyglucose positron emission tomography/computed tomography and inguinal sentinel lymph node biopsy in patients with anal cancer.
Aged
Anus Neoplasms
/ diagnostic imaging
Combined Modality Therapy
Female
Fluorodeoxyglucose F18
Humans
Inguinal Canal
Lymph Node Excision
Lymphatic Metastasis
/ pathology
Lymphoscintigraphy
Male
Middle Aged
Positron Emission Tomography Computed Tomography
Prognosis
Radiopharmaceuticals
Sensitivity and Specificity
Sentinel Lymph Node Biopsy
Anal cancer
FDG-PET/CT
inguinal sentinel lymph node biopsy
radiotherapy
Journal
Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland
ISSN: 1463-1318
Titre abrégé: Colorectal Dis
Pays: England
ID NLM: 100883611
Informations de publication
Date de publication:
Sep 2019
Sep 2019
Historique:
received:
09
10
2018
accepted:
12
04
2019
pubmed:
12
5
2019
medline:
29
10
2020
entrez:
12
5
2019
Statut:
ppublish
Résumé
The aim of this study was to assess the value of positron emission tomography (PET)/CT and sentinel lymph node (SLN) biopsy in staging inguinal lymph nodes in anal cancer patients and to determine if the results of the two methods could be of prognostic value. Sixty-three patients with anal cancer and clinically negative inguinal lymph nodes underwent lymphoscintigraphy and inguinal SLN biopsy and/or fluorodeoxyglucose (FDG) PET/CT scan. All patients were treated with radiotherapy combined with 5-fluorouracil and mitomycin-C. Overall (OS) and disease-free survival (DFS) were 43 months (range 5-211) and 43 months (range 4-142) respectively. PET/CT examination showed high FDG uptake in the inguinal lymph nodes in 25% of patients. Thirty-five patients with inguinal uptake at lymphoscintigraphy underwent inguinal SLN biopsy and metastatic nodes were found in 31.4%. There was no statistical difference in OS (55 vs 41 months; P = 0.652) and DFS (48 vs 38 months; P = 0.992) between the group which showed inguinal uptake on PET/CT and the group which did not, while a positive inguinal SLN was associated with a worse OS (28 vs 59 months; P = 0.028) and DFS (56 vs 21 months; P = 0.046). When the two examinations were compared PET/CT showed a sensitivity, specificity, positive predictive value and negative predictive value of 22%, 82%, 33% and 73% respectively. The technique of SLN biopsy had a better diagnostic accuracy than total body FDG-PET/CT for the staging of inguinal lymph nodes in anal cancer patients; moreover it was a stronger predictor of OS and DFS than PET/CT.
Substances chimiques
Radiopharmaceuticals
0
Fluorodeoxyglucose F18
0Z5B2CJX4D
Banques de données
GENBANK
['Neo2000']
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1017-1024Informations de copyright
Colorectal Disease © 2019 The Association of Coloproctology of Great Britain and Ireland.
Références
Shepherd NA, Scoffield JH, Love SB, England J, Northover JM. Prognostic factors in anal squamous cell carcinoma: a multivariate analysis of clinical, pathological and flow cytometric perimeters in 235 cases. Histopathology 1990; 16: 545-55.
Cotter SE, Grigsby PW, Siegel BA et al. FDG-PET/CT in the evaluation of anal carcinoma. Int J Radiat Oncol Biol Phys 2006; 65: 720-5.
Myerson RJ, Kong F, Birnbaum EH et al. Radiation therapy for epidermoid carcinoma of the anal canal, clinical and treatment factors associated with outcome. Radiother Oncol 2001; 61: 15-22.
Crowley C, Winship AZ, Hawkins MA, Morris SL, Leslie MD. Size does matter: can we reduce the radiotherapy field size for selected cases of anal canal cancer undergoing chemoradiation? Clin Oncol (R Coll Radiol) 2009; 21: 376e379.
Gretschel S, Warnick P, Bembenek A et al. Lymphatic mapping and sentinel lymph node biopsy in epidermoid carcinoma of the anal canal. Eur J Surg Oncol 2008; 34: 890-4.
De Nardi P, Carvello M, Staudacher C. New approach to anal cancer: individualized therapy based on sentinel lymph node biopsy. World J Gastroenterol 2012; 28: 6349-56.
Klas JV, Rothenberger DA, Wong WD, Madoff RD. Malignant tumors of the anal canal: the spectrum of disease, treatment, and outcomes. Cancer 1999; 85: 1686-93.
Glynne-Jones R, Sebag-Montefiore D, Adams R et al. Prognostic factors for recurrence and survival in anal cancer: generating hypotheses from the mature outcomes of the first United Kingdom Coordinating Committee on Cancer Research Anal Cancer Trial (ACT I). Cancer 2013; 119: 748-55.
Das P, Bhatia S, Eng C et al. Predictions and patterns of recurrence after definitive chemoradiation for anal cancer. Int J Radiat Oncol Biol Phys 2007; 68: 794-800.
Boman BM, Moertel CG, O'Connell MJ et al. Carcinoma of the anal canal. A clinical and pathologic study of 188 cases. Cancer 1984; 54: 114-25.
Stearns Jr MW, Urmacher C, Sternberg SS, Woodruff J, Attiyeh F. Cancer of the anal canal. Curr Probl Cancer 1980; 4: 1-44.
Ortholan C, Resbeut M, Hannoun-Levi JM et al. Anal canal cancer: management of inguinal nodes and benefit of prophylactic inguinal irradiation (CORS-03 Study). Int J Radiat Oncol Biol Phys 2012; 82: 1988-95.
Myerson RJ, Outlaw ED, Chang A et al. Radiotherapy for epidermoid carcinoma of the anus: thirty years’ experience. Int J Radiat Oncol Biol Phys 2009; 75: 428-35.
Gerard J-P, Chapet O, Samiei F et al. Management of inguinal lymph node metastases in patients with carcinoma of the anal canal. Experience in a series of 270 patients treated in Lyon and review of the literature. Cancer 2001; 92: 77-84.
Nguyen BT, Joon DL, Khoo V et al. Assessing the impact of FDG-PET in the management of anal cancer. Radiother Oncol 2008; 87: 376-82.
Jones M, Hruby G, Solomon M, Rutherford N, Martin J. The role of FDG-PET in the initial staging and response assessment of anal cancer: a systematic review and meta-analysis. Ann Surg Oncol 2015; 22: 3574-81.
Noorani A, Rabey N, Durrani A, Walsh SR, Davies RJ. Systematic review of sentinel lymph node biopsy in anal squamous cell carcinoma. Int J Surg 2013; 11: 762-6.
Gretschel S, Warnick P, Bembenek A et al. Lymphatic mapping and sentinel lymph node biopsy in epidermoid carcinoma of the anal canal. EJSO 2008; 34: 890e894.
Mistrangelo M, Pelosi E, Bellò M et al. Comparison of positron emission tomography scanning and sentinel node biopsy in the detection of inguinal node metastases in patients with anal cancer. Int J Radiat Oncol Biol Phys 2010; 77: 73-8.
Caldarella C, Annunziata S, Treglia G, Sadeghi R, Ayati N, Giovanella L. Diagnostic performance of positron emission tomography/computed tomography using fluorine-18 fluorodeoxyglucose in detecting locoregional nodal involvement in patients with anal canal cancer: a systematic review and meta-analysis. Sci World J 2014; 1-111.96068.
Mahmud A, Poon R, Jonker D. PET imaging in anal canal cancer: a systematic review and meta-analysis. Br J Radiol 2017; 90: 20170370.
De Nardi P, Carvello M, Canevari C, Passoni P, Staudacher C. Sentinel node biopsy in squamous-cell carcinoma of the anal canal. Ann Surg Oncol 2011; 18: 365-70.
Welton ML, Steele SR, Goodman KA et al. Anus. In: AJCC Cancer Staging Manual (ed. Amin MB), 8th Ed. New York: Springer, 2017: p. 275.