Isolated Mediastinal Lymph Node False Positivity of [18F]-Fluorodeoxyglucose-Positron Emission Tomography/Computed Tomography in Patients With Cervical Cancer

被引:20
作者
Onal, Cem [1 ]
Oymak, Ezgi [1 ]
Findikcioglu, Alper [2 ]
Reyhan, Mehmet [3 ]
机构
[1] Baskent Univ, Fac Med, Dept Radiat Oncol, TR-01120 Adana, Turkey
[2] Baskent Univ, Fac Med, Dept Thorac Surg, TR-01120 Adana, Turkey
[3] Baskent Univ, Fac Med, Dept Nucl Med, TR-01120 Adana, Turkey
关键词
Gynecological cancer; Cervical cancer; Positron emission tomography; False positivity; Metastasis; CELL LUNG-CANCER; GUIDELINES 2ND EDITION; FDG-PET; ONCOLOGY-GROUP; MANAGEMENT; CARCINOMA; ACCURACY;
D O I
10.1097/IGC.0b013e31827e00cc
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Objective: This study aimed to evaluate the degree of mediastinal involvement in patients with cervical cancer with isolated mediastinal [F-18]-fluorodeoxyglucose-positron emission tomography (FDG-PET) positivity as verified by histopathologic examination. Methods: Two hundred twenty-eight patients with newly diagnosed cervical cancer and who underwent FDG-PET imaging were analyzed. Twenty-nine patients (17%) had disseminated disease detected with PET/computed tomography (CT). Only 10 patients (4%) had increased FDG uptake in mediastinal lymph nodes alone. Of the 10 patients with mediastinal disease, 2 refused surgical mediastinal lymph node biopsy and did not receive any treatment. Patients with suspected paratracheal or subcarinal lymph node metastasis detected on PET/CT underwent mediastinoscopy, and those with hilar metastasis had video-assisted mediastinal lymphadenectomy. Treatment was delivered according to final staging based on histopathologic confirmation of mediastinal lymph node involvement. Results: The mean (SD) maximum standardized uptake values for primary cervical tumor and mediastinal lymph nodes were 19.7 (10.3) and 7.5 (1.6), respectively. Of 8 patients who underwent mediastinal lymph node confirmation, 6 (75%) were tumor free, demonstrating granulomatous changes, and were treated curatively. No patients had residual or recurrent disease at the primary site, and all but 1 were alive without disease. Two patients with confirmed mediastinal lymph node metastasis were treated palliatively and died between 9 and 11 months after diagnosis. Conclusions: Positron emission tomography/CT is an important tool for lymphatic staging and evaluation of distant metastases in cervical cancer. However, PET/CT should be interpreted cautiously for isolated mediastinal involvement; surgical evaluation is required for accurate staging and appropriate treatment decisions to achieve better outcomes.
引用
收藏
页码:337 / 342
页数:6
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