Positive pelvic lymph node on [18F]-FDG PET is a prognostic factor in early-stage high-risk cervical cancer treated by radical hysterectomy and adjuvant chemoradiotherapy

Abstract

Purpose: The prognostic value of [18F]-fluorodeoxyglucose positron emission tomography (FDG PET) in early-stage high-risk cervical cancer patients was evaluated. Materials and Methods: A total of 86 Stage IB or IIA cervical cancer patients with high risk factors (positive resection margin (RM), parametrial invasion (PI) or pelvic lymph node (PLN) metastasis) were retrospectively investigated. Results: There was a statistically significant decrease in recurrence-free survival (RFS) in patients with bulky tumor (p = 0.011), positive RM (p = 0.001), and PLN positivity on FDG PET (p = 0.012) in multivariate analyses. Independent prognostic factors for overall survival (OS) included non-squamous cell type (p = 0.005), bulky tumor (p = 0.020), and PLN positivity on FDG PET (p = 0.007). Patients with positive PLN on FDG PET had worse five-year RFS (62.0% vs. 85.0%, p = 0.013) and OS (68.7% vs. 89.5%, p = 0.011) rates than those with negative PLN uptake. Conclusion: PLN metastasis on FDG PET and bulky tumor were found to be statistically significant prognostic factors for both RFS and OS in early-stage high-risk cervical cancer patients.