We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Preoperative PET/CT does not accurately detect extrauterine disease in patients with newly diagnosed high-risk endometrial cancer: A prospective study.
- Authors
Stewart, Katherine I.; Chasen, Beth; Erwin, William; Fleming, Nicole; Westin, Shannon N.; Dioun, Shayan; Frumovitz, Michael; Ramirez, Pedro T.; Lu, Karen H.; Wong, Franklin; Aloia, Thomas A.; Soliman, Pamela T.
- Abstract
<bold>Background: </bold>The identification of extrauterine disease is critical to the management of patients with high-risk endometrial cancer. The purpose of the current study was to determine the accuracy of preoperative positron emission tomography (PET)/computed tomography (CT) in the detection of extrauterine disease.<bold>Methods: </bold>Women with high-risk endometrial cancer were enrolled prospectively and underwent preoperative PET/CT followed by surgery, including sentinel lymph node biopsy and lymphadenectomy. Primary tumor factors on PET/CT were correlated with lymph node pathology. The sensitivity, specificity, positive predictive value, and negative predictive value were calculated for the detection of lymphadenopathy and peritoneal disease by PET/CT.<bold>Results: </bold>A total of 112 patients were enrolled and underwent PET/CT between April 2013 and May 2016, 108 of whom were evaluable. On PET/CT, 21 patients (19.4%) were found to have extrauterine disease, 18 (17%) had positive lymph nodes, and 8 (7%) had peritoneal disease. A total of 108 patients underwent surgery, 103 of whom (95%) underwent lymphadenectomy. The sensitivity of PET/CT to detect positive lymph nodes was 45.8%, with a specificity of 91.1%, positive predictive value of 61.1%, and negative predictive value of 84.7%. The false-negative rate was 54.2%. There was no difference in primary tumor characteristics on imaging noted between patients with positive and negative lymph nodes. The sensitivity of PET/CT to detect peritoneal disease was 37.5%, with a specificity of 97.8%, positive predictive value of 75%, and negative predictive value of 90.0%. The false-negative rate was 62.5%.<bold>Conclusions: </bold>Preoperative PET/CT did not reliably predict the presence of extrauterine disease in women with high-risk endometrial cancer. Given the high false-negative rates, PET/CT should not be used in the preoperative treatment planning of these patients.
- Subjects
ENDOMETRIAL cancer; SENTINEL lymph node biopsy; LYMPHADENITIS; POSITRON emission tomography computed tomography; LONGITUDINAL method
- Publication
Cancer (0008543X), 2019, Vol 125, Issue 19, p3347
- ISSN
0008-543X
- Publication type
journal article
- DOI
10.1002/cncr.32329