The Role of Chest Computed Tomography in the Work-up of Patients with Cervical or Endometrial Cancer

Background and Objectives: To determine whether chest CT-scan in patients with cervical or endometrial cancer is of additional value for planning initial treatment and work-up. Methods: A retrospective analysis was performed of 465 patients diagnosed with cervical or endometrial cancer between January 2003 and December 2007. All patients who underwent a chest CT-scan before treatment were included for analysis. Results: Out of 465 patients 74 patients underwent a pre-treatment chest CT-scan (cervical cancer, n = 58, and endometrial cancer, n = 26). Abnormalities were detected in 53.4% (31/58) and 73.1% (19/26) of patients with cervical and endometrial cancer, respectively. The majority of abnormalities were presumed to be benign, yet work-up was adjusted in 28.6% (13/58 and 11/26), and therapy was adjusted in 17.6% (6/58, and 7/26) of patients with cervical and endometrial cancer. Pulmonary metastasis were observed in 10.3% (6/58) and 24.1% (7/26) of patients with cervical cancer, and endometrial cancer, respectively. Most patients with pulmonary metastasis presented with extended disease based on clinical examination. Conclusions: Chest CT scans in patients with cervical and endometrial cancer frequently demonstrate abnormalities that are most likely benign, yet work-up is adjusted in a substantial number of cases. Therefore, chest CT-scan is only recommended for those patients with a clinical suspicion of extended disease.