Whole-Body FDG-PET Scans Predict Survival of Cervical Cancer Patients

The location of lymph node metastases is linked to survival odds for cervical cancer patients, according to a new study presented October 7, 2002, at the American Society for Therapeutic Radiology and Oncology's Annual Meeting in New Orleans.

Forty patients with stage IIIB cervical carcinoma were treated between 1998 and 2002. Patients received a whole-body PET scan with the compound F-fluoro-2-deoxy-D-glucose (FDG). This pre-treatment FDG-PET scan revealed that 28 percent of patients (11 out of 40) had no evidence of lymph node metastases. Abnormal FDG uptake consistent with metastases was seen on pelvic nodes only in 45 percent (18 out of 40), in pelvic and para-aortic lymph nodes in 15 percent (6 out of 40), and in pelvic, para-aortic and supraclavicular lymph nodes in 13 percent (5 out of 40).

Most patients were treated with external irradiation, intracavitary brachytherapy and weekly cisplatin chemotherapy. The three-year progression-free survival for all patients was 48 percent. The three-year progression-free survival estimates were 68 percent for those with no lymph node metastases, 57 percent for those with only pelvic lymph node metastases, 33 percent for those with pelvic and para-aortic lymph node metastases and 0 percent for those with pelvic, para-aortic and supraclavicular lymph node metastases.

"FDG-PET scans accurately predict the outcome of these patients based on the site of their lymph node metastases," said Anurag K. Singh, M.D., and Perry W. Grigsby, M.D., of the Department of Radiation Oncology at Washington University School of Medicine and co-authors of the study. "The regional level of lymph node metastases was a valuable predictor of progression-free survival."