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Pelvic lymph node F-18 fluorodeoxyglucose uptake as a prognostic biomarker in newly diagnosed patients with locally advanced cervical cancer
Article first published online: 27 JAN 2010
Copyright © 2010 American Cancer Society
Volume 116, Issue 6, pages 1469–1475, 15 March 2010
How to Cite
Kidd, E. A., Siegel, B. A., Dehdashti, F. and Grigsby, P. W. (2010), Pelvic lymph node F-18 fluorodeoxyglucose uptake as a prognostic biomarker in newly diagnosed patients with locally advanced cervical cancer. Cancer, 116: 1469–1475. doi: 10.1002/cncr.24972
- Issue published online: 3 MAR 2010
- Article first published online: 27 JAN 2010
- Manuscript Accepted: 12 AUG 2009
- Manuscript Revised: 11 AUG 2009
- Manuscript Received: 30 JUN 2009
- F-18 fluorodeoxyglucose-positron emission tomography (FDG-PET);
- lymph nodes;
- standardized uptake value;
The objective of the current study was to evaluate the prognostic significance of the maximum standardized uptake value (SUVmax) of F-18 fluorodeoxyglucose (FDG) as measured by positron emission tomography (PET) in pelvic lymph nodes in patients with cervical cancer.
The authors studied cervical cancer patients with pelvic lymph node metastasis, as evidenced on FDG-PET, who were treated between November 2003 and October 2008. The maximum dimension and SUVmax for the most FDG-avid pelvic lymph node (SUVPLN) and the SUVmax of the primary cervical tumor (SUVcervix) were recorded from the FDG-PET/computed tomography (CT) scan. The SUVPLN was analyzed for its association with treatment response, pelvic disease recurrence, disease-specific survival, and overall survival.
The population was comprised of 83 women with International Federation of Gynecology and Obstetrics (FIGO) stages IB1 to IIIB cervical cancer. The average SUVPLN was 6.9 (range, 2.1-33.0), whereas the average SUVcervix was 14.0 (range, 3.2-38.4). The SUVcervix and SUVPLN were found to be weakly correlated (correlation coefficient [R2] = 0.301). The average size of the pelvic lymph nodes was 2.1 cm (range, 0.6-7.9 cm), and was also found to be only weakly associated with the SUVPLN (R2 = 0.225). The SUVPLN was found to be correlated with an increased risk of persistent disease after treatment (P = .0025), specifically within the pelvic lymph node region (P = .0003). The SUVPLN was found to be predictive of an increased risk of ever developing pelvic disease recurrence (P = .0035). Patients with a higher SUVPLN were found to have significantly worse disease-specific (P = .0230) and overall survival (P = .0378) using Kaplan‒Meier evaluation. A Cox proportional hazards model for the risk of pelvic disease recurrence was performed including SUVPLN, patient age, and tumor stage, and found only an increased SUVPLN to be an independent predictor.
SUVPLN is a prognostic biomarker, predicting treatment response, pelvic recurrence risk, and disease-specific survival in patients with cervical cancer. Cancer 2010. © 2010 American Cancer Society.