Diagnostic Value of 18F-fluorodeoxyglucose Positron Emission Tomography with Computed Tomography for Lymph Node Staging in Patients with Upper Tract Urothelial Carcinoma

Charlotte S Voskuilen, Donald Schweitzer, Jørgen Bjerggaard Jensen, Anna M Nielsen, Steven Joniau, Tim Muilwijk, Andrea Necchi, Mounsif Azizi, Philippe E Spiess, Alberto Briganti, Marco Bandini, Karolien Goffin, Kirsten Bouchelouche, Erik van Werkhoven, Shahrokh F Shariat, Evanguelos Xylinas, Nessn H Azawi, Ja Hyeon Ku, Beat Foerster, Bas W G van RhijnErik Vegt, Kees Hendricksen

Publikation: Bidrag til tidsskriftArtikelForskningpeer review

Abstrakt

BACKGROUND: Presence of lymph node metastases (LNM) is an important prognostic factor for cancer-specific survival (CSS) in patients with upper tract urothelial carcinoma (UTUC). In various neoplasms, 18F-fluorodeoxyglucose positron emission tomography with computed tomography (FDG-PET/CT) is an established modality for preoperative lymph node (LN) staging. In UTUC, the diagnostic value of FDG-PET/CT for LN staging is unknown.

OBJECTIVE: To determine the diagnostic value of FDG-PET/CT for LN staging in patients with UTUC.

DESIGN, SETTING, AND PARTICIPANTS: Data of 152 patients with UTUC who underwent FDG-PET/CT followed by surgical treatment in eight centers between 2007 and 2017 were retrospectively collected. Patients receiving neoadjuvant chemotherapy were excluded.

OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: FDG-PET/CT results were compared with histopathology after lymph node dissection (LND). Recurrence-free survival (RFS), CSS, and overall survival (OS) were analyzed using Kaplan-Meier estimates, and compared for patients with and without suspicious LNs on FDG-PET/CT.

RESULTS AND LIMITATIONS: We included 117 patients, of whom 62 underwent LND. Seventeen patients had LNM at histopathological evaluation. Sensitivity and specificity of FDG-PET/CT for diagnosis of LNM were 82% (95% confidence interval [CI]: 57-96) and 84% (95% CI: 71-94), respectively. RFS was significantly worse in patients with LN-positive FDG-PET/CT than in those with LN-negative FDG-PET/CT (p=0.03). CSS (p=0.11) and OS (p=0.5) were similar between groups. This study is limited by its retrospective design and by its sample size. Our results warrant further validation.

CONCLUSIONS: FDG-PET/CT has 82% sensitivity and 84% specificity for the detection of LNM in patients with UTUC. Presence of suspicious LNs on FDG-PET/CT is associated with worse RFS.

PATIENT SUMMARY: In patients with upper tract urothelial cancer, positron emission tomography with computed tomography (PET/CT) scans can detect lymph node metastases with noteworthy accuracy. Presence of suspicious lymph nodes on 18F-fluorodeoxyglucose PET/CT is associated with worse recurrence-free survival.

OriginalsprogEngelsk
Sider (fra-til)73-79
Antal sider7
TidsskriftEuropean urology oncology
Vol/bind3
Udgave nummer1
Tidlig onlinedato2019
DOI
StatusUdgivet - 1 feb. 2020

Bibliografisk note

Copyright � 2019 European Association of Urology. Published by Elsevier B.V. All rights reserved.

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Udforsk hvilke forskningsemner 'Diagnostic Value of 18F-fluorodeoxyglucose Positron Emission Tomography with Computed Tomography for Lymph Node Staging in Patients with Upper Tract Urothelial Carcinoma' indeholder.

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