2022-RA-797-ESGO PET/CT negative predictive value in locally advanced cervical cancer. (20th October 2022)

• Record Type: Journal Article
• Authors: Gonzalez, Elena Rodriguez; Gracia, Myriam; Romero, Violeta; Carbonell, María; García, Virginia; Siegrist, Jaime; Zapardiel, Ignacio; Diestro, Maria Dolores; Hernández, Alicia
• Is Part Of: International journal of gynecological cancer. Volume 32(2022)Supplement 2
• Page Start: A27
• Page End: A27
• Publication Date: 2022-10-20
• Subjects: Generative organs, Female -- Cancer -- Periodicals; 616.99465
• DOI: 10.1136/ijgc-2022-ESGO.59
• Languages: English
• ISSNs: 1048-891X

Abstract

Abstract : Introduction/Background: Para-aortic lymph nodes involvement in locally advanced cervical cancer is a determining factor in patient´s treatment as it determines radiotherapy field. PET/CT is used to assess lymph node involvement at this level, although it is not exempt from false negatives. Our aim is to compare PET/CT with para-aortic (PA) lymphadenectomy, in order to assess the false negative rate of this test, as well as the factors associated with a greater probability of false negatives. Methodology: Retrospective descriptive study: Cases of locally advanced cervical cancer with negative PET/CT that underwent para-aortic lymphadenectomy from 2018 to 2022 were collected. During recruitment period, a new PET/CT technique was developed. Outcomes of both types of PET/CT were compared. Results: A total of 11 patients underwent radiological node staging with the first type of PET/CT and 12 patients with the new one. Mean age was 52, 09 (±15, 3). Epidermoid was the most frequent subtype (65, 2%). Mean time between PET/CT and surgery were 21.77 days (±10.53). Mean number of lymph nodes obtained were 12.48 (±5.10). 91.3% (21) of patients had a negative pathological result and 8.7% (2) were positive (PET/CT false negatives). One patient presented macrometastasis and one patient isolated tumor cells. Negative predictive value of first type of PET/CT was 0.90 and that of the new one was 0.91. One of false negative cases had a unilaterally positive pelvic PET/CT and the other bilaterally. Conclusion: Our false negative rate of PET/CT was similar to that described in literature. No significant differences between the two types of PET/CT were observed. Pelvic lymph node involvement seems to be associated with a higher false negative PET/CT. After analyzing our data, we don´t have enough evidence to avoid performing PA lymphadenectomy in these patients as routine, having to individualize the risk-benefit in each case.