ArticleEuropean journal of nuclear medicine and molecular imaging2020
Tumour and pelvic lymph node metabolic activity on FDG-PET/CT to stratify patients for para-aortic surgical staging in locally advanced cervical cancer.
Article in European journal of nuclear medicine and molecular imaging, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.
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Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it, 39 citations in OpenAlex.
- The Diagnosis, Treatment, and Aftercare of Cervical Carcinoma.Deutsches Arzteblatt international · 2021Pooled it
- Para-Aortic Lymph Node Staging and Oncologic Outcomes in Locally Advanced Cervical Cancer: A Narrative Review.Cancers · 2026Review
- Nonmetastatic Para-aortic Lymph Node Remodeling as a Predictor of Outcome in Locally Advanced Cervical Cancer.Clinical cancer research : an official journal of the American Association for Cancer Research · 2026Article
- Article
- Surgical Staging in Locally Advanced Cervical Cancer: Precision, Risks, and the 'Helmet' Analogy.Cancers · 2025Article
- Precision matters: the value of PET/CT and PET/MRI in the clinical management of cervical cancer.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2025Review
- Risk Factor Analysis and Prediction of Para-Aortic Lymph Node Metastases in Locally Advanced Cervical Cancer.Cancer medicine · 2024Article
- Predictive Model of Paraaortic Lymph Node Involvement in cN0 Locally Advanced Cervical Cancers: PET/CT Technology Matters.Diagnostics (Basel, Switzerland) · 2024Article
- Para-aortic and pelvic lymphadenectomy in locally advanced cervical cancer with pelvic lymph node metastasis.World journal of surgical oncology · 2024Article
- Based on 3D-PDU and clinical characteristics nomogram for prediction of lymph node metastasis and lymph-vascular space invasion of early cervical cancer preoperatively.BMC women's health · 2024Article
- Autocrine and paracrine effects of MDK promote lymph node metastasis of cervical squamous cell carcinoma.iScience · 2024Article
- Validation of the 2018 FIGO staging system for stage IIIC cervical cancer by determining the metabolic and radiomic heterogeneity of primary tumors based onAbdominal radiology (New York) · 2024Article
- Article
- Lymph node assessment in cervical cancer: current approaches.Frontiers in oncology · 2024Review
- Staging of Cervical Cancer: A Practical Approach Using MRI and FDG PET.AJR. American journal of roentgenology · 2023Review
- Multicentric development and evaluation ofEuropean journal of nuclear medicine and molecular imaging · 2023Article
- Association of Sialyl Tn antigen with cervical cancer lymph node status: An NRG oncology/GOG study.Gynecologic oncology · 2023Article
- Metabolic activity determines survival depending on the level of lymph node involvement in cervical cancer.BMC cancer · 2022Article
- Assessment of Lymph Node Involvement with PET-CT in Advanced Epithelial Ovarian Cancer. A FRANCOGYN Group Study.Journal of clinical medicine · 2021Article
- The Role of the Metabolic Parameters ofFrontiers in oncology · 2021Article
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Authors and funding
14 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe aim of our study was to comprehensively evaluate the most valuable metabolic parameters of cervical tumours and pelvic lymph nodes (PLN) by FDG-PET/CT to predict para-aortic lymph node (PALN) metastasis and stratify patients for surgical staging.
methodsThe study included patients with locally advanced cervical cancer, negative PALN uptake on preoperative FDG-PET/CT, and para-aortic lymphadenectomy. Two senior nuclear medicine physicians expert in gynaecologic oncology reviewed all PET/CT exams, and extracted tumour SUVmax, MTV, and TLG, as well as PLN. Prognostic parameters of PALN involvement were identified using ROC curves and logistic regression analysis.
resultsOne hundred and twenty-five consecutive locally advanced cervical cancer patients were included. The FDG-PET/CT false-negative rate was, respectively, 27.7% (13/47) and 5.1% (4/78) in patients with and without FDG-PET/CT PLN uptake. The AUC of cervical tumour size, SUVmax, MTV, and TLG was, respectively, 0.75 (0.62-0.87), 0.59 (0.44-0.76), 0.75 (0.60-0.90), and 0.71 (0.56-0.86). The AUC of PLN size, SUVmax, SUVmean, PLN SUVmax/Tumour SUVmax ratio, MTV, and TLG was, respectively, 0.57 (0.37-0.78), 0.82 (0.68-0.95), 0.77 (0.61-0.94), 0.85 (0.72-0.98), 0.69 (0.51-0.87), and 0.74 (0.57-0.91). The metabolic parameter showing the best trade-off between sensitivity and specificity to predict PALN involvement was the ratio between PLN and tumour SUVmax.
conclusionThe risk of PALN metastasis in FDG-PET/CT negative PLN patients is very low, so para-aortic lymphadenectomy does not seem justified. In patients with preoperative PLN uptake on FDG-PET/CT, surgical staging led to treatment modification in more than 25% of cases and should therefore be performed. Patients with more than one positive PLN and high PLN metabolic activity are at high risk of para-aortic extension and recurrence. Further prospective evaluation is required to consider intensified treatment modalities without prior PALN dissection.
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