FDG-PET lymph node staging and survival of patients with FIGO stage IIIb cervical carcinoma

Int J Radiat Oncol Biol Phys. 2003 Jun 1;56(2):489-93. doi: 10.1016/s0360-3016(02)04521-2.


Purpose: To evaluate the outcome of patients with International Federation of Gynecology and Obstetrics (FIGO) clinical Stage IIIb cervical carcinoma as a function of site of initial regional lymph node metastasis as detected by 2[18F]fluoro-2-deoxy-D-glucose (FDG)-positron emission tomography (PET).

Methods and materials: Forty-seven patients with FIGO Stage IIIb cervical cancer were evaluated before therapy with whole-body FDG-PET. Most patients were treated with external beam irradiation, intracavitary brachytherapy, and weekly cisplatin for six cycles. Overall and cause-specific survival rates were calculated by the Kaplan-Meier method.

Results: The pretreatment whole-body FDG-PET demonstrated that all patients had FDG uptake in the cervix. Of 47 patients, 13 (28%) had no evidence of lymph node metastasis, 20 (43%) had metastasis to pelvic lymph nodes only, 7 (15%) had pelvic and para-aortic lymph node metastases, and 7 (15%) had metastases to pelvic, para-aortic, and supraclavicular lymph nodes. The 3-year estimate of cause-specific survival was 73% for those with no lymph node metastasis, 58% for those with only pelvic lymph node metastasis, 29% for those with pelvic and para-aortic lymph node metastases, and 0% for those with pelvic, para-aortic, and supraclavicular lymph node metastasis (p = 0.0005).

Conclusion: The cause-specific survival for patients with FIGO Stage IIIb carcinoma is highly dependent on the extent of lymph node metastasis as demonstrated by whole-body FDG-PET.

MeSH terms

  • Adult
  • Aged
  • Brachytherapy
  • Carcinoma, Adenosquamous / diagnostic imaging*
  • Carcinoma, Adenosquamous / mortality
  • Carcinoma, Adenosquamous / radiotherapy
  • Carcinoma, Adenosquamous / secondary
  • Carcinoma, Squamous Cell / diagnostic imaging*
  • Carcinoma, Squamous Cell / mortality
  • Carcinoma, Squamous Cell / radiotherapy
  • Carcinoma, Squamous Cell / secondary
  • Female
  • Fluorodeoxyglucose F18*
  • Humans
  • Lymphatic Metastasis / diagnostic imaging
  • Middle Aged
  • Neoplasm Staging / methods
  • Radiopharmaceuticals*
  • Radiotherapy / methods
  • Radiotherapy Dosage
  • Retrospective Studies
  • Survival Rate
  • Tomography, Emission-Computed*
  • Uterine Cervical Neoplasms / diagnostic imaging*
  • Uterine Cervical Neoplasms / mortality
  • Uterine Cervical Neoplasms / pathology
  • Uterine Cervical Neoplasms / radiotherapy


  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18