FDG-PET/CT and Para-Aortic Staging in Endometrial Cancer. A French Multicentric Study.
FDG-PET/CT
endometrial cancer
high risk
lymphadenectomy
para-aortic
Journal
Journal of clinical medicine
ISSN: 2077-0383
Titre abrégé: J Clin Med
Pays: Switzerland
ID NLM: 101606588
Informations de publication
Date de publication:
17 Apr 2021
17 Apr 2021
Historique:
received:
18
02
2021
revised:
08
04
2021
accepted:
15
04
2021
entrez:
30
4
2021
pubmed:
1
5
2021
medline:
1
5
2021
Statut:
epublish
Résumé
FDG-PET/CT is a noninvasive examination that could be helpful for the management of endometrial cancer. The aim of this study was to evaluate the performance of FDG-PET/CT in assessing para-aortic lymph-node involvement in high-risk endometrial cancer. We performed a retrospective multicenter study including all patients who had a high-risk endometrial cancer with a preoperative FDG-PET/CT and a para-aortic lymphadenectomy (PAL) between 2009 and 2019. The main objective was to evaluate the overall performance of FDG-PET/CT. The secondary objectives were to evaluate its performances according to the histological type and according to FDG-PET/CT date (before or after hysterectomy), and to compare its overall performance with that of the MRI scan. We included 200 patients from six different centers. After the false positive FDG-PET/CT was reread by nuclear physicians, FDG-PET/CT had a sensitivity of 61.8%, a specificity of 89.7%, a positive predictive value of 69.4%, a negative predictive value of 86.1%, and an AUC of 0.76. There were no statistically significant differences in the performances according to either histological type and or FDG-PET/CT date. The sensitivity of FDG-PET/CT was better than that of MRI ( Currently, FDG-PET/CT alone cannot replace PAL for the lymph node evaluation of high-risk endometrial cancers. It seems essential to reread it in multidisciplinary meetings before validating the therapeutic management of patients, particularly in the case of isolated para-aortic involvement.
Sections du résumé
BACKGROUND
BACKGROUND
FDG-PET/CT is a noninvasive examination that could be helpful for the management of endometrial cancer. The aim of this study was to evaluate the performance of FDG-PET/CT in assessing para-aortic lymph-node involvement in high-risk endometrial cancer.
METHODS
METHODS
We performed a retrospective multicenter study including all patients who had a high-risk endometrial cancer with a preoperative FDG-PET/CT and a para-aortic lymphadenectomy (PAL) between 2009 and 2019. The main objective was to evaluate the overall performance of FDG-PET/CT. The secondary objectives were to evaluate its performances according to the histological type and according to FDG-PET/CT date (before or after hysterectomy), and to compare its overall performance with that of the MRI scan.
RESULTS
RESULTS
We included 200 patients from six different centers. After the false positive FDG-PET/CT was reread by nuclear physicians, FDG-PET/CT had a sensitivity of 61.8%, a specificity of 89.7%, a positive predictive value of 69.4%, a negative predictive value of 86.1%, and an AUC of 0.76. There were no statistically significant differences in the performances according to either histological type and or FDG-PET/CT date. The sensitivity of FDG-PET/CT was better than that of MRI (
CONCLUSION
CONCLUSIONS
Currently, FDG-PET/CT alone cannot replace PAL for the lymph node evaluation of high-risk endometrial cancers. It seems essential to reread it in multidisciplinary meetings before validating the therapeutic management of patients, particularly in the case of isolated para-aortic involvement.
Identifiants
pubmed: 33920565
pii: jcm10081746
doi: 10.3390/jcm10081746
pmc: PMC8074207
pii:
doi:
Types de publication
Journal Article
Langues
eng
Références
Eur J Cancer. 2019 Jul;116:77-85
pubmed: 31181536
Lancet Oncol. 2018 Mar;19(3):295-309
pubmed: 29449189
Gynecol Oncol. 1997 Mar;64(3):411-7
pubmed: 9062142
Lancet Oncol. 2017 Mar;18(3):384-392
pubmed: 28159465
Eur J Nucl Med Mol Imaging. 2006 Jan;33(1):36-44
pubmed: 16167154
Ann Surg Oncol. 2014 Aug;21(8):2755-61
pubmed: 24705578
Gynecol Obstet Fertil Senol. 2017 Dec;45(12):715-725
pubmed: 29132772
Gynecol Oncol. 2013 Aug;130(2):306-11
pubmed: 23707673
J Surg Oncol. 1997 Jun;65(2):82-7
pubmed: 9209518
Lancet Oncol. 2012 May;13(5):e212-20
pubmed: 22554549
PeerJ. 2019 Jul 15;7:e7081
pubmed: 31341726
Gynecol Oncol. 2013 Feb;128(2):300-8
pubmed: 23200916
Ann Nucl Med. 2016 Feb;30(2):104-13
pubmed: 26546334
Radiology. 2017 May;283(2):450-459
pubmed: 28051912
Rev Esp Med Nucl Imagen Mol. 2017 Jan - Feb;36(1):20-26
pubmed: 27667001
AJR Am J Roentgenol. 2008 Jun;190(6):1652-8
pubmed: 18492920
World J Nucl Med. 2014 Sep;13(3):170-7
pubmed: 25538488
Best Pract Res Clin Obstet Gynaecol. 2015 Aug;29(6):845-57
pubmed: 25817745
Int J Gynecol Cancer. 2007 Jul-Aug;17(4):890-6
pubmed: 17343574
Gynecol Oncol. 2008 Mar;108(3):486-92
pubmed: 18201753
Cochrane Database Syst Rev. 2010 Jan 20;(1):CD007585
pubmed: 20091639
Bull Cancer. 2015 May;102(5):428-35
pubmed: 25956349
Lancet Oncol. 2011 May;12(5):469-76
pubmed: 21489874
Ann Nucl Med. 2011 May;25(4):269-75
pubmed: 21547477
Ann Surg Oncol. 2017 Aug;24(8):2303-2310
pubmed: 28550488
Eur Radiol. 2020 May;30(5):2443-2453
pubmed: 32034487
Int J Gynecol Cancer. 2013 Nov;23(9):1536-43
pubmed: 24172090
Eur J Radiol. 2013 Oct;82(10):1672-6
pubmed: 23727380
Ann Oncol. 2016 Jan;27(1):16-41
pubmed: 26634381
Anticancer Res. 2019 Feb;39(2):619-625
pubmed: 30711937
Br J Cancer. 1997;75(12):1836-41
pubmed: 9192991
Gynecol Oncol. 2013 May;129(2):292-7
pubmed: 23480871