EP087/#838 PET-CT findings of para-aortic adenopathy predict survival in women living with HIV and cervical cancer

Objectives

PET-CT imaging is an ideal staging modality to identify nodal involvement in locally advanced cervical carcinoma (LACC). Previous work from this group has shown that PET-CT findings did not differ by HIV status and that PET-CT was a useful tool in this setting. The cohort was subsequently followed for survival outcomes.

Methods

Patients with LACC FIGO Stage IIb or IIIB were referred for fluorine-18 fluorodeoxyglucose PET-CT based on stage and booking availability between January 2015 and December 2018. Descriptive statistics and Kaplan-Meier estimates were generated to evaluate overall survival (OS) after 2 years of follow-up. All patients were censored by December 2020.

Results

Of the 278 patients included in the cohort, 86 (30.9%) were HIV-positive. 105 (37.8%) had pelvic nodal lesions, and 77 (27.7%) had additional para-aortic adenopathy (PAN). Overall survival (OS) for the cohort, including those found to have distant disease, was 52.9% (HIV-negative) and 42.4% (HIV-positive) (p=0.12). For the 192 patients who received radical treatment, 2-year OS by stage and HIV status (negative vs. positive) was as follows: IIIB 75% vs 62.5% (p=0.86); IIIc1r 72.5% vs 54.2% (p=0.09) and IIIc2r 43.9% vs 41.2% (p=0.86). Survival rates were (marginally) associated with HIV status only in stage IIIc1r. PAN involvement conferred a poor prognosis.

Conclusions

PET-CT findings of para-aortic lymphadenopathy in LACC were prognostic for a poor outcome at 2 years, irrespective of HIV status. PET-CT remains a valuable tool in the HIV-positive patient group.