FDG-PET in carcinoma of the uterine cervix with endometrial extension

BACKGROUND. The authors wished to determine whether pretreatment pathologic evidence of endometrial invasion correlated with fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) findings and outcomes in patients with carcinoma of the uterine cervix. METHODS. Pretreatment whole body FDG-PET was performed in 58 patients with cervical carcinoma who also under-went pathologic evaluation of the endometrium by biopsy or dilation and curettage. FDG-PET lymph node status, disease free survival, and overall survival were evaluated. RESULTS. Thirty seven (64%) patients had pathologic evidence of endometrial invasion. Pelvic lymph node metastases were three times more frequent in patients with evidence of endometrial invasion compared with those without endometrial invasion (70% vs. 23%, P < 0.001). Patients with endometrial invasion also had a significantly increased risk of paraaortic and supraclavicular lymph node metastases at presentation (30% vs. 0% P = 0.006). Endometrial invasion was associated with a decreased 2-year disease-free survival (78% vs. 58%, P = 0.046) and overall survival (92% vs. 65%, P = 0.047). CONCLUSIONS. Endometrial extension in cervical cancer correlated strongly with risk of FDG-PET detected lymph node metastases in this study's population and was associated with a poor prognosis.