Staging Locally Advanced Uterine Cervical Carcinoma With Positron Emission Tomography—Computed Tomography [9P]

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Abstract

INTRODUCTION:

Uterine cervical cancer is the third most frequent cancer among Brazilian women. Cervical cancer is staged following the International Federation of Gynaecology and Obstetrics (FIGO) system based on physical examination that is not sufficiently accurate to identify nodal involvement, the most important variable for survival. The aim of this study is to compare clinical staging of uterine cervical cancer with the results of Positron Emission Tomography/Computed Tomography (PET/CT) with [18F]-fluoro-2-deoxy-D-glucose (FDG) in Northeast of Brazil.

METHODS:

This cross section study was conducted in a reference hospital in Northeast of Brazil. Women aged 18–70 years with newly and histologically proven squamous cell carcinoma of uterine cervix, International Federation of Gynaecology and Obstetrics (FIGO) stages IB2–IVB and Eastern Cooperative Oncology Group (ECOG) performance status 0–2 were included. All the patients were submitted to FDG PET/CT. Staging with and without FDG PET/CT were compared and Kappa coefficient was calculated. The rates of upstage and downstage were calculated with 95% confidence intervals. A 5% significance level was adopted.

RESULTS:

A total of 51 consecutive patients with locally advanced uterine cervical cancer were included. A poor agreement was found between FIGO and PET/CT staging (Kappa=0.06). There were 40 cases of disagreement between clinical and FDG PET/CT staging. Thirty-eight of them were upstaged (95%) and two downstaged (5%). Of those upstaged, 15 (39.4%) were classified as stage IVB—distant metastasis.

CONCLUSION:

This study shows that the use of FDG PET/CT improves staging patients with locally advanced cervical carcinoma by identifying distant abnormal lymph nodes.

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