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KMID : 1137020160270020015
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Journal of Gynecologic Oncology
2016 Volume.27 No. 2 p.15 ~ p.15
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Prognostic value of preoperative intratumoral FDG uptake heterogeneity in early stage uterine cervical cancer
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Chung Hyun-Hoon
Kang Seo-Young
Ha Seung-Gyun
Kim Jae-Weon
Park Noh-Hyun
Song Yong-Sang
Cheon Gi-Jeong
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Abstract
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Objective: We investigated the prognostic value of intratumoral [18F]fluorodeoxyglucose (FDG) uptake heterogeneity (IFH) derived from positron emission tomography/computed tomography (PET/CT) in patients with cervical cancer.
Methods: Patients with uterine cervical cancer of the International Federation of Obstetrics and Gynecology (FIGO) stage IB to IIA were imaged with [18F]FDG PET/CT before radical surgery. PET/CT parameters such as maximum and average standardized uptake values (SUVmax and SUVavg), metabolic tumor volume (MTV), total lesion glycolysis (TLG), and IFH were assessed. Regression analyses were used to identify clinicopathological and imaging variables associated with progression-free survival (PFS).
Results: We retrospectively reviewed clinical data of 85 eligible patients. Median PFS was 32 months (range, 6 to 83 months), with recurrence observed in 14 patients (16.5%). IFH at an SUV of 2.0 was correlated with primary tumor size (p<0.001), SUVtumor (p<0.001), MTVtumor (p<0.001), TLGtumor (p<0.001), depth of cervical invasion (p<0.001), and negatively correlated with age (p=0.036). Tumor recurrence was significantly associated with TLGtumor (p<0.001), MTVtumor (p=0.001), SUVLN (p=0.004), IFH (p=0.005), SUVtumor (p=0.015), and FIGO stage (p=0.015). Multivariate analysis identified that IFH (p=0.028; hazard ratio, 756.997; 95% CI, 2.047 to 279,923.191) was the only independent risk factor for recurrence. The Kaplan-Meier survival graphs showed that PFS significantly differed in groups categorized based on IFH (p=0.013, log-rank test).
Conclusion: Preoperative IFH was significantly associated with cervical cancer recurrence. [18F]FDG based heterogeneity may be a useful and potential predicator of patient recurrence before treatment.
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KEYWORD
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FDG PET/CT, Intratumoral, Population Characteristics, Uterine Cervical Neoplasms
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