Purpose The aim of this study was to evaluate the role of PET/CT and sentinel lymph node (SLN) biopsy in staging high-risk endometrial cancer patients (G2 and deep myometrial invasion, G3, serous clear cell carcinoma or carcinosarcoma) in early clinical stage. Patients and Methods From January 2006 to December 2012, high-risk early-stage endometrial cancer patients performing PET/CT scan followed by surgery (systematic pelvic ± aortic lymphadenectomy) were included. From December 2010, SLN mapping with <sup>99m</sup>Tc-albumin nanocolloid and blue dye cervical injection was included in our clinical practice and additionally performed. Histological findings were used as the reference standard. Results Ninety-three patients were included, of which 22 of 93 had both PET/CT and SLN biopsy. The median number of dissected lymph nodes (LNs) was 28. Nineteen women (20.4%) had pelvic LN metastases; 14 were correctly identified by PET/CT. Among 5 false-negative cases, 3 occurred after the introduction of SLN mapping due to detection of micrometastases by ultrastaging. On overall patient-based analysis, the sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of PET/CT for pelvic LN metastases were 73.7%, 98.7%, 93.6%, 93.3%, 93.6%, respectively. Conclusions PET/CT demonstrated moderate sensitivity and high specificity in detecting pelvic LN metastases; its high positive predictive value (93.3%) is useful to refer patients to appropriate debulking surgery. Sentinel LN mapping and histological ultrastaging increased the identification of metastases (incidence, 18.3%-27.3%) not detectable by PET/CT because of its spatial resolution. The combination of both modalities is promising for nodal staging purpose.
Signorelli, M., Crivellaro, C., Buda, A., Guerra, L., Fruscio, R., Elisei, F., et al. (2015). Staging of High-Risk Endometrial Cancer With PET/CT and Sentinel Lymph Node Mapping. CLINICAL NUCLEAR MEDICINE, 40(10), 780-785 [10.1097/RLU.0000000000000852].
|Citazione:||Signorelli, M., Crivellaro, C., Buda, A., Guerra, L., Fruscio, R., Elisei, F., et al. (2015). Staging of High-Risk Endometrial Cancer With PET/CT and Sentinel Lymph Node Mapping. CLINICAL NUCLEAR MEDICINE, 40(10), 780-785 [10.1097/RLU.0000000000000852].|
|Tipo:||Articolo in rivista - Articolo scientifico|
|Carattere della pubblicazione:||Scientifica|
|Presenza di un coautore afferente ad Istituzioni straniere:||No|
|Titolo:||Staging of High-Risk Endometrial Cancer With PET/CT and Sentinel Lymph Node Mapping|
|Autori:||Signorelli, M; Crivellaro, C; Buda, A; Guerra, L; Fruscio, R; Elisei, F; Dolci, C; Cuzzocrea, M; Milani, R; Messa, C|
SIGNORELLI, MAURO (Primo)
CRIVELLARO, CINZIA (Secondo) (Corresponding)
MILANI, RODOLFO (Penultimo)
MESSA, MARIA CRISTINA (Ultimo)
|Data di pubblicazione:||2015|
|Rivista:||CLINICAL NUCLEAR MEDICINE|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1097/RLU.0000000000000852|
|Appare nelle tipologie:||01 - Articolo su rivista|