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Integration of PET/CT Into the Preoperative Evaluation of Patients With Early Cervical Cancer Does Not Decrease the Proportion of Patients With Positive Lymph Nodes Found After Surgery
  1. Ofer Gemer, MD*,
  2. Ram Eitan, MD,
  3. Michael Gdalevich, MD, MPH*,
  4. Ala Mamanov, MD*,
  5. Benjamin Piura, MD, FRCOG,
  6. Alex Rabinovich, MD,
  7. Hanoch Levavi, MD,
  8. Bozhena Saar-Ryss, MD*,
  9. Reuvit Halperin, MD§,
  10. Shahar Finci, MD,
  11. Uzi Beller, MD,
  12. Ilan Bruchim, MD,
  13. Tally Levy, MD#,
  14. Inbar Ben-Shachar, MD**,
  15. Amichai Meirovitz, MD,,
  16. Alon Ben Arie, MD, and
  17. Ofer Lavie, MD§§
  1. *Barzilai Medical Center, Ashkelon, Ben Gurion University of the Negev;
  2. Rabin Medical Center, Petah Tikva, Tel Aviv University;
  3. Soroka Medical Center, Beer Sheva, Ben Gurion University of the Negev;
  4. §Assaf Harofe Medical Center, Tzrifin, Tel Aviv University;
  5. Shaare Zedek Medical Center, Jerusalem, Hebrew University;
  6. Meir Medical Center, Kfar Saba, Tel Aviv University;
  7. #Wolfson Medical Center, Holon, Tel Aviv University;
  8. **Hadassah Medical Center-Mt Scopus, Jerusalem, Hebrew University;
  9. ††Sharett Institute of Oncology, Hadassah Medical Center, Jerusalem, Hebrew University;
  10. ‡‡Kaplan Medical Center, Rehovot, Hebrew University; and
  11. §§Carmel Medical Center, Haifa, Technion Institute, Israel.
  1. Address correspondence and reprint requests to Ram Eitan, MD, Department of Obstetrics and Gynecology, Rabin Medical Center, Jabutinsky St, Petah Tikva, 49100 Israel. E-mail: eitanr{at}clalit.org.il; eitanram{at}yahoo.com.

Abstract

Purpose The aim of this study was to evaluate whether preoperative positron emission tomography/computed tomography (PET/CT) in patients with early-stage cervical carcinoma reduced the proportion of patients with metastatic lymph nodes identified after surgery.

Patients and Methods This is a multicenter case-control study of 599 patients with early cervical cancer who underwent radical hysterectomy and pelvic lymphadenectomy at 1 of 10 gynecological oncology units in Israel. The patients were divided into 2 groups according to whether or not they underwent a preoperative PET/CT. The primary outcome was the proportion of patients with nodal involvement. The 2 groups were compared with regard to the clinical and histological variables.

Results Of the 599 patients who underwent surgery, 180 (36%) had preoperative PET/CT study. There were no significant differences between the PET/CT and control groups with regard to clinical and histological risk factors. The proportion of patients with involved nodes was similar in the control and PET/CT groups (20.8% vs 19%; P = 0.73) as well as the proportion of patients receiving adjuvant radiotherapy/chemoradiation (58.3% vs 55.1%; P = 0.55).

Conclusions Preoperative PET/CT in patients with early cervical cancer does not reduce proportion of patients with metastatic nodal involvement and the employment of multimodality treatment. Prospective clinical trials comparing management based on PET/CT findings are warranted.

  • Cervical cancer
  • PET/CT
  • Surgery
  • Lymph nodes

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Footnotes

  • The authors declare no conflicts of interest.

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