Diagnostic Value of


Journal

European urology oncology
ISSN: 2588-9311
Titre abrégé: Eur Urol Oncol
Pays: Netherlands
ID NLM: 101724904

Informations de publication

Date de publication:
02 2020
Historique:
received: 23 07 2019
revised: 06 09 2019
accepted: 17 09 2019
pubmed: 9 10 2019
medline: 6 11 2020
entrez: 9 10 2019
Statut: ppublish

Résumé

Presence of lymph node metastases (LNM) is an important prognostic factor for cancer-specific survival (CSS) in patients with upper tract urothelial carcinoma (UTUC). In various neoplasms, To determine the diagnostic value of FDG-PET/CT for LN staging in patients with UTUC. Data of 152 patients with UTUC who underwent FDG-PET/CT followed by surgical treatment in eight centers between 2007 and 2017 were retrospectively collected. Patients receiving neoadjuvant chemotherapy were excluded. FDG-PET/CT results were compared with histopathology after lymph node dissection (LND). Recurrence-free survival (RFS), CSS, and overall survival (OS) were analyzed using Kaplan-Meier estimates, and compared for patients with and without suspicious LNs on FDG-PET/CT. We included 117 patients, of whom 62 underwent LND. Seventeen patients had LNM at histopathological evaluation. Sensitivity and specificity of FDG-PET/CT for diagnosis of LNM were 82% (95% confidence interval [CI]: 57-96) and 84% (95% CI: 71-94), respectively. RFS was significantly worse in patients with LN-positive FDG-PET/CT than in those with LN-negative FDG-PET/CT (p=0.03). CSS (p=0.11) and OS (p=0.5) were similar between groups. This study is limited by its retrospective design and by its sample size. Our results warrant further validation. FDG-PET/CT has 82% sensitivity and 84% specificity for the detection of LNM in patients with UTUC. Presence of suspicious LNs on FDG-PET/CT is associated with worse RFS. In patients with upper tract urothelial cancer, positron emission tomography with computed tomography (PET/CT) scans can detect lymph node metastases with noteworthy accuracy. Presence of suspicious lymph nodes on

Sections du résumé

BACKGROUND
Presence of lymph node metastases (LNM) is an important prognostic factor for cancer-specific survival (CSS) in patients with upper tract urothelial carcinoma (UTUC). In various neoplasms,
OBJECTIVE
To determine the diagnostic value of FDG-PET/CT for LN staging in patients with UTUC.
DESIGN, SETTING, AND PARTICIPANTS
Data of 152 patients with UTUC who underwent FDG-PET/CT followed by surgical treatment in eight centers between 2007 and 2017 were retrospectively collected. Patients receiving neoadjuvant chemotherapy were excluded.
OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS
FDG-PET/CT results were compared with histopathology after lymph node dissection (LND). Recurrence-free survival (RFS), CSS, and overall survival (OS) were analyzed using Kaplan-Meier estimates, and compared for patients with and without suspicious LNs on FDG-PET/CT.
RESULTS AND LIMITATIONS
We included 117 patients, of whom 62 underwent LND. Seventeen patients had LNM at histopathological evaluation. Sensitivity and specificity of FDG-PET/CT for diagnosis of LNM were 82% (95% confidence interval [CI]: 57-96) and 84% (95% CI: 71-94), respectively. RFS was significantly worse in patients with LN-positive FDG-PET/CT than in those with LN-negative FDG-PET/CT (p=0.03). CSS (p=0.11) and OS (p=0.5) were similar between groups. This study is limited by its retrospective design and by its sample size. Our results warrant further validation.
CONCLUSIONS
FDG-PET/CT has 82% sensitivity and 84% specificity for the detection of LNM in patients with UTUC. Presence of suspicious LNs on FDG-PET/CT is associated with worse RFS.
PATIENT SUMMARY
In patients with upper tract urothelial cancer, positron emission tomography with computed tomography (PET/CT) scans can detect lymph node metastases with noteworthy accuracy. Presence of suspicious lymph nodes on

Identifiants

pubmed: 31591037
pii: S2588-9311(19)30145-2
doi: 10.1016/j.euo.2019.09.004
pii:
doi:

Substances chimiques

Fluorodeoxyglucose F18 0Z5B2CJX4D

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

73-79

Informations de copyright

Copyright © 2019 European Association of Urology. Published by Elsevier B.V. All rights reserved.

Auteurs

Charlotte S Voskuilen (CS)

Department of Urology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.

Donald Schweitzer (D)

Department of Urology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.

Jørgen Bjerggaard Jensen (JB)

Department of Urology, Aarhus University Hospital, Aarhus, Denmark.

Anna M Nielsen (AM)

Department of Urology, Aarhus University Hospital, Aarhus, Denmark.

Steven Joniau (S)

Department of Urology, UZ Leuven, Leuven, Belgium.

Tim Muilwijk (T)

Department of Urology, UZ Leuven, Leuven, Belgium.

Andrea Necchi (A)

Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.

Mounsif Azizi (M)

Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, FL, USA.

Philippe E Spiess (PE)

Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, FL, USA.

Alberto Briganti (A)

Division of Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, Milan, Italy.

Marco Bandini (M)

Division of Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, Milan, Italy.

Karolien Goffin (K)

Department of Nuclear Medicine, UZ Leuven, Leuven, Belgium; Department of Imaging and Pathology, KU Leuven, Leuven, Belgium.

Kirsten Bouchelouche (K)

Department of Nuclear Medicine and PET-Centre, Aarhus University Hospital, Aarhus, Denmark.

Erik van Werkhoven (E)

Department of Biometrics, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.

Shahrokh F Shariat (SF)

Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia.

Evanguelos Xylinas (E)

Department of Urology, Bichat-Claude Bernard Hospital, Paris, France.

Nessn H Azawi (NH)

Department of Urology, Zealand University Hospital, Roskilde, Denmark.

Ja Hyeon Ku (JH)

Department of Urology, Seoul National University Hospital, Seoul, South Korea.

Beat Foerster (B)

Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.

Bas W G van Rhijn (BWG)

Department of Urology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.

Erik Vegt (E)

Department of Nuclear Medicine, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.

Kees Hendricksen (K)

Department of Urology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands. Electronic address: k.hendricksen@nki.nl.

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