Introduction/Background Nodal involvement is the most important negative prognostic factor for patients with cervical cancer. Therefore, lymph node assessment is of utmost importance to tailor these patients‘ treatment of these patients. In this regard, PET/CT is considered the gold standard in preoperative assessment of lymph nodes, with a reported sensitivity and a specificity of 76% and 94%, respectively.

The aim of this study was to assess the value of a negative PET/TC in detecting paraaortic nodal involvement in patients with locally advanced cervical cancer undergoing paraaortic lymph node dissection (PALND).

Methodology We present a retrospective observational study. We selected patients with diagnosis of preoperative locally advanced cervical cancer (FIGO stage IIB/IIIC1) without suspicious metastatic paraortic lymph nodes in preoperative PET/TC, and who had undergone PALND for staging between January 2017 to December 2022.

Qualitative variables were expressed as absolute and relative frequency. Continuous variables were expressed as mean (Standard deviation; SD) and median (Interquartile range; IQR) according to a normality test (Kolmogorov-Smirnov test). All analyses were performed with Stata V.16.

Results A total of 22 patients were selected. Clinicopathologic characteristics are described in table 1. All of them had a preoperative PET/TC without suspicion of metastatic para-aortic lymph nodes and underwent PALND. The surgical approach was retroperitoneal in 18 cases (81.8%) and a mean of 9.3 paraaortic lymph nodes were removed per patient. None of the nodes removed were positive for metastasis.

Conclusion The probability of paraaortic lymph node involvement in patients diagnosed of preoperative locally advanced cervical cancer (FIGO stage II B/IIIC1) without suspicious metastatic paraaortic lymph nodes in preoperative PET/TC is extremely low. Therefore, staging PALND could be avoided in these patients.

Disclosures Roche, Medtroniz, Storz, Baxter.