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Significance of PET-CT as the preoperative evaluation in endometrial cancer

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ESGO State of the Art 2018 Conference

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Abstract

【Objective】 Diagnosis of lymph node metastasis is necessary for staging and decision-making on the postoperative treatment strategy for endometrial cancer. However, lymph node dissection is the only diagnostic method because noninvasive tests such as imaging cannot identify microscopic lymph node metastasis. Positron emission tomography-computed tomography (PET-CT) is used to detect the presence of lymph node and distant metastases in Japan. Only few studies have evaluated the usefulness of PET-CT. In this study, we aimed to examine the significance of PET-CT as a preoperative evaluation modality for lymph node metastasis. 【Methods】 We included 206 patients with endometrial cancer who underwent preoperative workup using PET-CT. They underwent operation between August 2008 and June 2016. We retrospectively evaluated the accuracy of the preoperative diagnosis of lymph node metastasis. 【Results】 The median age of the patients was 59 years (range, 25–89 years). The postoperative stage was stage I in 143, stage Ⅱ in 17, stage Ⅲ in 40, and stage Ⅳ in 6 cases. The pathological diagnosis was endometrioid carcinoma in 168, serous carcinoma in 13, clear cell carcinoma in 5, mucous carcinoma in 1, carcinosarcoma in 12, and mixed carcinoma in 7 patients. Lymph node metastasis was detected in 37 patients (18%). For the detection of pelvic or para-aortic lymph node metastasis, the sensitivity, specificity, and positive and negative predictive values were 57%, 94%, 68%, and 91%, respectively. 【Conclusion】 For endometrial cancer, preoperative PET-CT showed high specificity and negative predictive value.

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© Copyright 2020 Morressier GmbH.
All rights reserved.