caa a22 4500 445336595 CHVBK 20180317142757.0 cr unu---uuuuu 170323e20110801xx s 000 0 eng 10.1245/s10434-011-1583-9 doi (NATIONALLICENCE)springer-10.1245/s10434-011-1583-9 Accuracy of 18-Fluoro-2-deoxy- d -glucose Positron Emission Tomography in the Pretherapeutic Detection of Occult Para-aortic Node Involvement in Patients with a Locally Advanced Cervical Carcinoma [Elektronische Daten] [E. Leblanc, H. Gauthier, D. Querleu, G. Ferron, S. Zerdoud, P. Morice, C. Uzan, S. Lumbroso, F. Lecuru, A. Bats, N. Ghazzar, M. Bannier, G. Houvenaeghel, I. Brenot-Rossi, F. Narducci] Purpose: Patients with locally advanced cervical cancer (LACC) are usually treated with concurrent chemoradiotherapy. Extended-field chemoradiotherapy is indicated in case of para-aortic node involvement at initial assessment. 18-Fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography (18-FDG PET/CT) is currently considered to be the most accurate method of detection of node or distant metastases. The goal of this study was to evaluate the accuracy of PET at detecting para-aortic lymph node metastases in LACC patients with a negative morphological imaging. Methods: Patients from five French institutions with LACC and both negative morphologic (magnetic resonance imaging, CT scan) and functional (PET or PET/CT) findings at the para-aortic level and distantly were submitted to a systematic infrarenal para-aortic node dissection either by laparoscopy or laparotomy. On the basis of pathological results, sensitivity, specificity, and positive and negative predictive values of PET/CT were assessed for para-aortic lymph node involvement. Results: A total of 125 LACC patients (stage IB2-IVA disease with two local recurrences) fulfilled the inclusion criteria. All had an ilio-infrarenal para-aortic lymphadenectomy, either by laparoscopy (n=117) or laparotomy (n=8). Twenty-one patients (16.8%) had pathologically proven para-aortic metastases. Among them, 14 (66.7%) had negative PET/CT. Overall morbidity of surgery was 7.2%. All but one of the complications were mild and did not delay chemoradiotherapy. Sensitivity, specificity, and positive and negative predictive value of the PET/CT were 33.3, 94.2, 53.8, and 87.5%, respectively, for the detection of microscopic lymph node metastases. Conclusions: Laparoscopic staging surgery seems warranted in LACC patients with negative PET scan who are candidates for definitive concurrent chemoradiotherapy or exenteration. Society of Surgical Oncology, 2011 Leblanc E. Centre Oscar Lambret, Lille, France aut Gauthier H. Centre Oscar Lambret, Lille, France aut Querleu D. Centre Claudius Regaud, Toulouse, France aut Ferron G. Centre Claudius Regaud, Toulouse, France aut Zerdoud S. Centre Claudius Regaud, Toulouse, France aut Morice P. Institut Gustave Roussy, Villejuif, France aut Uzan C. Institut Gustave Roussy, Villejuif, France aut Lumbroso S. Institut Gustave Roussy, Villejuif, France aut Lecuru F. Service de chirurgie gynécologique et cancérologique, Hôpital Européen Georges Pompidou, Paris, France aut Bats A. Service de chirurgie gynécologique et cancérologique, Hôpital Européen Georges Pompidou, Paris, France aut Ghazzar N. Service de chirurgie gynécologique et cancérologique, Hôpital Européen Georges Pompidou, Paris, France aut Bannier M. Centre Paoli Calmettes, Marseille, France aut Houvenaeghel G. Centre Paoli Calmettes, Marseille, France aut Brenot-Rossi I. Centre Paoli Calmettes, Marseille, France aut Narducci F. Centre Oscar Lambret, Lille, France aut Annals of Surgical Oncology Springer-Verlag 18/8(2011-08-01), 2302-2309 1068-9265 18:8<2302 2011 18 10434 https://doi.org/10.1245/s10434-011-1583-9 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-011-1583-9 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Leblanc E. Centre Oscar Lambret, Lille, France aut NATIONALLICENCE 700 1- Gauthier H. Centre Oscar Lambret, Lille, France aut NATIONALLICENCE 700 1- Querleu D. Centre Claudius Regaud, Toulouse, France aut NATIONALLICENCE 700 1- Ferron G. Centre Claudius Regaud, Toulouse, France aut NATIONALLICENCE 700 1- Zerdoud S. Centre Claudius Regaud, Toulouse, France aut NATIONALLICENCE 700 1- Morice P. Institut Gustave Roussy, Villejuif, France aut NATIONALLICENCE 700 1- Uzan C. Institut Gustave Roussy, Villejuif, France aut NATIONALLICENCE 700 1- Lumbroso S. Institut Gustave Roussy, Villejuif, France aut NATIONALLICENCE 700 1- Lecuru F. Service de chirurgie gynécologique et cancérologique, Hôpital Européen Georges Pompidou, Paris, France aut NATIONALLICENCE 700 1- Bats A. Service de chirurgie gynécologique et cancérologique, Hôpital Européen Georges Pompidou, Paris, France aut NATIONALLICENCE 700 1- Ghazzar N. Service de chirurgie gynécologique et cancérologique, Hôpital Européen Georges Pompidou, Paris, France aut NATIONALLICENCE 700 1- Bannier M. Centre Paoli Calmettes, Marseille, France aut NATIONALLICENCE 700 1- Houvenaeghel G. Centre Paoli Calmettes, Marseille, France aut NATIONALLICENCE 700 1- Brenot-Rossi I. Centre Paoli Calmettes, Marseille, France aut NATIONALLICENCE 700 1- Narducci F. Centre Oscar Lambret, Lille, France aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/8(2011-08-01), 2302-2309 1068-9265 18:8<2302 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer