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EP1219 Added value of para-aortic surgical staging compared to F18 FDG PET/CT on the external beam radiation field of patients with locally advanced cervical cancer: an ONCO-GF study
  1. M De Cuypere1,
  2. P Lovinfosse2,
  3. F Goffin1,
  4. S Schoenen1,
  5. R Rovira3,
  6. J Duch4,
  7. M Fastrez5,
  8. G Gebhart6,
  9. M Luyckx7,
  10. J-L Squifflet7,
  11. G Charaf8,
  12. K Crener9,
  13. F Buxant10,
  14. D Bucella11,
  15. M Jouret12 and
  16. C Gennigens13
  1. 1Department of Gynaecological Oncology, University of Liège
  2. 2Department of Nuclear Medicine, University of Liège, Liège, Belgium
  3. 3Department of Gynaecological Oncology and Laparoscopy, Hospital de la Santa Creu I Sant Pau of Barcelona
  4. 4Department of Nuclear Medicine, Hospital de la Santa Creu i Sant Pau of Barcelona, Barcelona, Spain
  5. 5Department of Gynaecology, St Pierre University Hospital, Free University of Brussels
  6. 6Department of Nuclear Medicine, Institut Jules Bordet, Free University of Brussels
  7. 7Department of Gynaecology, Saint Luc Academic Hospital, Catholic University of Louvain, Brussels, Belgium
  8. 8Department of Obstetrics and Gynaecology, University Hospital Ambroise Paré of Mons, Lille, France
  9. 9Department of Obstetrics and Gynaecology, University Hospital Ambroise Paré of Mons, Mons
  10. 10Department of Obstetrics and Gynaecology, Iris South Hospital
  11. 11Department of Nuclear Medicine, Iris South Hospital, Brussels
  12. 12Department of Obstetrics and Gynaecology, Hospital of Picard Wallonia, Tournai
  13. 13Department of Medical Oncology, University of Liège, Liège, Belgium


Introduction/Background Extended field chemoradiation is recommended for patients with locally advanced cervical cancer (LACC) and para-aortic lymph node (PALN) metastases. The radiation planning may be based on the positron emission tomography-computed tomography (PET/CT) while others recommend to rely on a surgical staging. We report the rate of patients for whom the radiation field defined on a PET/CT basis was modified by the histological PALN status.

Methodology Between March 2010 and December 2016, 168 consecutive patients with LACC underwent a pre-therapeutic PET/CT and PALN dissection. The data were reviewed retrospectively. The diagnostic performance of the PET/CT for definition of PALN status was calculated. We determined the percentage of patients for whom PALN dissection altered the external beam radiation treatment (EBRT) field defined on the PET/CT basis.

Results Of the 151 patients with negative PALNs on PET/CT, 26 had histological PALN metastasis. Of the 17 patients with positive PALNs on PET/CT, 9 were negative on histology. Seven of these 9 false positive cases were located in the common iliac region. Sensitivity, specificity, positive and negative predictive value of PET/CT were 23.5, 93.3, 47.1 and 82.8% respectively. In total, 35 out of 168 patients underwent EBRT-field adaptation (pelvic vs extended field). The rate of radiation field modification was particularly high (27,7%) in the subgroup of patients with metastatic pelvic lymph nodes (PLNs) on PET/CT.

Conclusion Para-aortic surgical staging contributes significantly to individualize the radiation treatment of patients with LACC, particularly for those with positive PLN at PET/CT. Indication of surgical staging deserves particular attention when the PET/CT suggests positive lymph nodes in the common iliac region.

Disclosure Nothing to disclose.

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