Endometrial cancer: preop PET/CT unreliable for extrauterine disease

  • Stewart KI & al.
  • Cancer
  • 21 Jun 2019

  • curated by Deepa Koli
  • Univadis Clinical Summaries
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Takeaway

  • Preoperative positron emission tomography (PET)/CT fails to detect the positive lymph nodes and metastatic disease in more than half the patients with high-risk endometrial cancer.

Why this matters

  • Findings suggest that preoperative PET/CT is not a reliable primary tool for initial preoperative evaluation, staging, or surgical planning.

Study design

  • Study of 108 patients with newly diagnosed high-risk endometrial cancer who underwent preoperative PET/CT followed by surgery during 2013-2016.
  • Outcome: detection rates of positive lymph nodes and peritoneal disease.
  • Funding: National Institutes of Health; National Cancer Institute SPORE in Uterine Cancer.

Key results

  • On PET/CT, 19.4% of patients had extrauterine disease, 17% had positive lymph nodes, and 7% had peritoneal disease.
  • 95% of the patients underwent pelvic and para-aortic lymphadenectomy.
  • For lymph nodes and peritoneal disease, respectively, PET/CT showed:
    • Sensitivity of 45.8% and 37.5%.
    • Specificity of 91.1% and 97.8%.
    • Positive predictive value of 61.1% and 75%.
    • Negative predictive value of 84.7% and 90.0%, respectively.
    • False-negative rate of 54.2% and 62.5%.

Limitations

  • Single-center study.