Surveillance FDG-PET detection of asymptomatic recurrences in patients with cervical cancer

Rebecca A. Brooks, Janet S. Rader, Farrokh Dehdashti, David G. Mutch, Matthew A. Powell, Premal H. Thaker, Barry A. Siegel, Perry W. Grigsby

Research output: Contribution to journalArticlepeer-review

76 Scopus citations

Abstract

Objectives: To evaluate survival after detection of recurrent cervical cancer by FDG-PET in symptomatic versus asymptomatic patients. Methods: This is a prospective registry study of 103 patients treated with definitive chemoradiation for advanced cervical cancer who demonstrated no abnormal FDG uptake (a complete metabolic response, CMR) on their 3-month posttherapy FDG-PET. Their median age was 48 years (range 26-84). The clinical stages were Ib in 38, IIa in 1, IIb in 39, and IIIb in 25. All patients underwent subsequent surveillance FDG-PET. Patients were grouped according to symptom status at the time of the surveillance FDG-PET. Recurrence sites and survival data were analyzed. Results: The median time from the 3-month posttherapy FDG-PET to the first surveillance FDG-PET was 13 months. 25 patients (25/103; 24%) were symptomatic at the time of surveillance FDG-PET and 21 of these had FDG-PET findings indicative of recurrence. 78 patients (78/103; 76%) were asymptomatic and 9 of these had tumor recurrence detected by PET. All recurrences were confirmed by biopsy or radiologic progression. The recurrences in the 21 symptomatic patients were loco regional in 4 and distant in 17. The 9 asymptomatic patients had isolated loco regional disease in 8 and distant disease in 1. All patients received treatment for recurrence. The three-year cause-specific survival for symptomatic recurrences was 19% versus 59% for asymptomatic recurrences (p = 0.09). Conclusions: Surveillance FDG-PET can detect asymptomatic recurrent disease that is potentially amenable to salvage therapy. Prospective investigation of surveillance PET is warranted.

Original languageEnglish (US)
Pages (from-to)104-109
Number of pages6
JournalGynecologic Oncology
Volume112
Issue number1
DOIs
StatePublished - Jan 2009
Externally publishedYes

Keywords

  • Cervix cancer
  • FDG/PET
  • Radiation
  • Recurrence

ASJC Scopus subject areas

  • Oncology
  • Obstetrics and Gynecology

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