Maximum standardized lymph node uptake value could be an important predictor of recurrence and survival in patients with cervical cancer

ObjectivesTo investigate prognostic values of maximum standardized lymph node (LN) uptake (SUVmax), minimum apparent LN diffusion coefficient (ADCmin), and LN short-axis length in women with cervical cancer.Study designRetrospective review of diffusion-weighted magnetic resonance imaging (DWI) and positron emission tomography/computed tomography (PET/CT) of LN confined to the pelvis in 80 cervical cancer patients before undergoing radiotherapy (RT) with or without concurrent chemotherapy. Optimal cut-off values for disease-free survival (DFS) and overall survival (OS) were determined by receiver operating characteristic (ROC) curve analysis. We used ROC curve analyses to evaluate whether LN SUVmax, LN ADCmin and LN short-axis length predicted risk of recurrence or survival.ResultsMedian DFS and OS for all patients were 18.97 and 22.28 months, respectively. DFS and OS rates of patients with high LN SUVmax was significantly lower than those of patients exhibiting low LN SUVmax (P = 0.003 and P = 0.019). Patients with low LN ADCmin had poorer DFS and OS than those with high LN ADCmin (P = 0.033 and P = 0.005). DFS for patients exhibiting longer LN short-axis length was significantly lower than those of patients exhibiting shorter LN short-axis length (P = 0.018). Multivariate analyses indicated that high LN SUVmax was an independent predictor for both DFS and OS (P = 0.0231 and P = 0.0146).ConclusionsLN SUVmax could be an important predictor of recurrence and survival in patients with cervical cancer confined to the pelvis.