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Role of [18F]fluoro-2-deoxy-D-glucose positron emission tomography in re-recurrent cervical cancer
  1. C.-T. Lin*,
  2. T.-C. Yen,
  3. T.-C. Chang*,
  4. K.-K. Ng,
  5. C.-S. Tsai§,
  6. K.-C. Ho and
  7. C.-H. Lai*
  1. * Departments of Obstetrics and Gynecology University College of Medicine, Taoyuan, Taiwan
  2. Nuclear Medicine and Chang Gung University College of Medicine, Taoyuan, Taiwan
  3. Diagnostic Radiology and Chang Gung University College of Medicine, Taoyuan, Taiwan
  4. § Radiation Oncology, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan, Taiwan
  1. Address correspondence and reprint requests to: Chyong-Huey Lai, MD, Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, 5 Fu-Shin Street, Kueishan, Taoyuan 333, Taiwan. Email: sh46erry{at}ms6.hinet.net

Abstract

Cervical cancer patients with histologically documented re-recurrence after curative salvage therapy or unexplained tumor marker elevation (negative computed tomography and/or magnetic resonance imaging [CT-MRI]) proven to be a re-recurrence when a further attempt for cure (or control of cancer) appeared feasible were enrolled. Lesion status was determined from pathology or clinical follow-up for at least 12 months. Management decisions were recorded with CT-MRI alone and incorporating [18F]fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET), respectively. The benefits calculated were based on clinical impact because of the FDG-PET findings. Cox proportional hazards model was used to select independent prognostic covariates. Of the 26 patients who were eligible for analysis, 12 (46.2%) patients had positive impacts due to PET. Squamous cell carcinoma (SCC, P= 0.029), re-recurrence at distant metastasis only (P= 0.012), and level of SCC antigen ≤4 ng/mL (P= 0.005) were significantly associated with better survival. A scoring system using these covariates defined three distinct prognostic groups (P= 0.0001). Patients with score 0 had a 36-month cumulative survival rate of 80%. Using this prognostic scoring system, FDG-PET may facilitate selecting appropriate management for the individual patient with re-recurrent cervical cancer.

  • FDG-PET
  • prognosis
  • recurrent cervical cancer
  • resalvage

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