FDG-PET/CT and Para-Aortic Staging in Endometrial Cancer. A French Multicentric Study

被引:9
作者
Sallee, Camille [1 ]
Margueritte, Francois [1 ]
Gouy, Sebastien [2 ]
Tardieu, Antoine [1 ]
Belghiti, Jeremie [3 ]
Lambaudie, Eric [4 ,5 ]
Collinet, Pierre [6 ]
Guyon, Frederic [7 ]
Legros, Maxime [1 ]
Monteil, Jacques [8 ]
Gauthier, Tristan [1 ,9 ]
机构
[1] CHU Limoges, Dept Gynaecol & Obstet, F-87042 Limoges, France
[2] Gustave Roussy Comprehens Canc Ctr, Dept Surg, F-94800 Villejuif, France
[3] Pitie Salpetriere, AP HP, Dept Gynecol & Breast Surg & Oncol, F-75013 Paris, France
[4] Inst Paoli Calmettes, F-13009 Marseille, France
[5] CRCM, F-13009 Marseille, France
[6] Univ Hosp Lille, Jeanne de Flandre Hosp, Gynaecol Surg Unit, F-59000 Lille, France
[7] Inst Bergonie, F-33000 Bordeaux, France
[8] Limoges Univ Hosp, Dept Nucl Med, F-87042 Limoges, France
[9] Fac Med, UMR 1248, F-87000 Limoges, France
关键词
endometrial cancer; FDG-PET; CT; lymphadenectomy; para-aortic; high risk;
D O I
10.3390/jcm10081746
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: FDG-PET/CT is a noninvasive examination that could be helpful for the management of endometrial cancer. The aim of this study was to evaluate the performance of FDG-PET/CT in assessing para-aortic lymph-node involvement in high-risk endometrial cancer. Methods: We performed a retrospective multicenter study including all patients who had a high-risk endometrial cancer with a preoperative FDG-PET/CT and a para-aortic lymphadenectomy (PAL) between 2009 and 2019. The main objective was to evaluate the overall performance of FDG-PET/CT. The secondary objectives were to evaluate its performances according to the histological type and according to FDG-PET/CT date (before or after hysterectomy), and to compare its overall performance with that of the MRI scan. Results: We included 200 patients from six different centers. After the false positive FDG-PET/CT was reread by nuclear physicians, FDG-PET/CT had a sensitivity of 61.8%, a specificity of 89.7%, a positive predictive value of 69.4%, a negative predictive value of 86.1%, and an AUC of 0.76. There were no statistically significant differences in the performances according to either histological type and or FDG-PET/CT date. The sensitivity of FDG-PET/CT was better than that of MRI (p < 0.01), but the specificity was not (p = 0.82). Conclusion: Currently, FDG-PET/CT alone cannot replace PAL for the lymph node evaluation of high-risk endometrial cancers. It seems essential to reread it in multidisciplinary meetings before validating the therapeutic management of patients, particularly in the case of isolated para-aortic involvement.
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页数:12
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