Department of Nuclear Medicine and Molecular Imaging Center, Chang Gung University, Taoyuan, Taiwan.
Gynecol Oncol. 2011 Nov;123(2):253-6. doi: 10.1016/j.ygyno.2011.07.020. Epub 2011 Jul 31.
Patients with cervical cancer and supraclavicular lymph nodes (SLN) recurrence have a poor but heterogeneous prognosis. The aim of this study was to identify potential prognostic factors - including FDG-PET results - that may affect survival and treatment outcomes in patients with this group of patients.
Between January 2001 and December 2008, we identified a total of 31 consecutive patients with cervical cancer who had evidence of SLN recurrence. All participants underwent FDG-PET. Survival was measured from the date of documented SLN recurrence. The latency period was defined as the length of time from the date of first diagnosis to the date of SLN recurrence.
The median follow-up time was 22.8 months (range: 4.7-105.1). The 3- and 5-year survival rates were 41% and 27.3%, respectively. Patients with intermediate SUV values (between 4.3 and 8) had a significantly better prognosis than subjects with both high (>8) or low (<4.3) SUV values (p=0.004). Latency period <2 years, SCC-Ag levels ≥ 4ng/mL, recurrence extend beyond SLN, and SUV of <4.3 >8 were significant adverse prognostic factors by multivariate analysis. The 3-year overall survival (OS) rate of patients carrying 0-1 adverse prognostic factors was 90% (low-risk group), while 3-year OS rates for intermediate-risk group (2 factors) and high-risk group (3-4 factors) were 30% and 0%, respectively (p=0.001).
Our results justify the use of PET (accurate extent of relapse and SUV) as a prognostic tool in patients with cervical cancer and SLN recurrence.
患有宫颈癌和锁骨上淋巴结（SLN）复发的患者预后较差，但具有异质性。本研究的目的是确定可能影响这组患者生存和治疗结果的潜在预后因素 - 包括 FDG-PET 结果。
2001 年 1 月至 2008 年 12 月期间，我们共确定了 31 例连续患有宫颈癌且有 SLN 复发证据的患者。所有参与者均接受 FDG-PET 检查。生存时间从 SLN 复发的日期开始计算。潜伏期定义为从首次诊断到 SLN 复发的时间长度。
中位随访时间为 22.8 个月（范围：4.7-105.1）。3 年和 5 年生存率分别为 41%和 27.3%。SUV 值在 4.3 到 8 之间的患者的预后明显优于 SUV 值高（>8）或低（<4.3）的患者（p=0.004）。潜伏期<2 年、SCC-Ag 水平≥4ng/mL、复发超出 SLN 以及 SUV 值<4.3>8 是多因素分析中的显著不良预后因素。携带 0-1 个不良预后因素的患者 3 年总生存率（OS）为 90%（低危组），而中危组（2 个因素）和高危组（3-4 个因素）的 3 年 OS 率分别为 30%和 0%（p=0.001）。
我们的结果证明了 PET（准确的复发范围和 SUV）在宫颈癌和 SLN 复发患者中作为预后工具的使用。
