TY - JOUR T1 - 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 JF - International Journal of Gynecologic Cancer JO - Int J Gynecol Cancer SP - A45 LP - A45 DO - 10.1136/ijgc-2019-ESGO.52 VL - 29 IS - Suppl 4 AU - M De Cuypere AU - P Lovinfosse AU - F Goffin AU - S Schoenen AU - R Rovira AU - J Duch AU - M Fastrez AU - G Gebhart AU - M Luyckx AU - J-L Squifflet AU - G Charaf AU - K Crener AU - F Buxant AU - D Bucella AU - M Jouret AU - C Gennigens Y1 - 2019/11/01 UR - http://ijgc.bmj.com/content/29/Suppl_4/A45.1.abstract N2 - 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. ER -