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Kirsten Bouchelouche

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

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avis › Tidsskriftartikel › Forskning › peer review

DOI

  • Charlotte S Voskuilen, Department of Urology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
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  • Donald Schweitzer, Department of Urology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
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  • Jørgen Bjerggaard Jensen
  • Anna Munk Nielsen, Department of Urology, Aarhus University Hospital, Aarhus, Denmark.
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  • Steven Joniau, Department of Urology, UZ Leuven, Leuven, Belgium.
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  • Tim Muilwijk, Department of Urology, UZ Leuven, Leuven, Belgium.
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  • Andrea Necchi, Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
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  • Mounsif Azizi, Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, FL, USA.
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  • Philippe E Spiess, Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, FL, USA.
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  • Alberto Briganti, Division of Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, Milan, Italy.
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  • Marco Bandini, Division of Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, Milan, Italy.
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  • Karolien Goffin, Department of Nuclear Medicine, UZ Leuven, Leuven, Belgium; Department of Imaging and Pathology, KU Leuven, Leuven, Belgium.
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  • Kirsten Bouchelouche
  • Erik van Werkhoven, Department of Biometrics, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
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  • Shahrokh F Shariat, Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia.
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  • Evanguelos Xylinas, Department of Urology, Bichat-Claude Bernard Hospital, Paris, France.
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  • Nessn H Azawi, Department of Urology, Zealand University Hospital, Sygehusvej 10, 4000, Roskilde, Denmark.
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  • Ja Hyeon Ku, Department of Urology, Seoul National University Hospital, Seoul, South Korea.
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  • Beat Foerster, Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.
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  • Bas W G van Rhijn, Department of Urology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
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  • Erik Vegt, Department of Nuclear Medicine, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
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  • Kees Hendricksen, Department of Urology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands. Electronic address: k.hendricksen@nki.nl.

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
TidsskriftEuropean urology oncology
Vol/bind3
Nummer1
Sider (fra-til)73-79
Antal sider7
ISSN2588-9311
DOI
StatusUdgivet - 2020

Bibliografisk note

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

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