Preoperative [18F]FDG PET/CT maximum standardized uptake value predicts recurrence of uterine cervical cancer.
OBJECTIVE
To determine if preoperative [(18)F]FDG-PET/CT imaging has prognostic significance in patients with uterine cervical cancer.


METHODS
Patients with FIGO stage IB to IIA cervical cancer were imaged with integrated FDG PET/CT before radical surgery. The relationship between the maximum standardized uptake value (SUV(max)) of FDG in the primary tumour during PET/CT and recurrence was examined.


RESULTS
Included in the study were 75 patients. Medical records including clinical data, treatment modalities, and treatment results were retrospectively reviewed. The median duration of follow-up was 13 months (range 3 to 58 months) after treatment. Median preoperative SUV(max) values in the primary tumours were significantly higher in patients with higher FIGO stages (p = 0.0149), pelvic lymph node metastasis (p = 0.0068), parametrial involvement (p = 0.0002), large (>4 cm) tumour size (p = 0.0022), presence of lymphovascular space invasion (p = 0.0055), and deep cervical stromal invasion (p < 0.0001). In univariate analysis, lymph node metastasis, parametrial invasion, presence of lymphovascular space invasion, and preoperative SUV(max) (uncategorized values) in the primary tumour were significantly associated with recurrence. However, in multivariate analysis, preoperative SUV(max) (p = 0.014, HR 1.178, 95% CI 1.034-1.342), age (p = 0.021, HR 0.87, 95% CI 0.772-0.980), and parametrial involvement (p = 0.040, HR 27.974, 95% CI 1.156-677.043) by primary tumour were significantly associated with recurrence.


CONCLUSIONS
Preoperative FDG uptake by the primary tumour showed a significant association with recurrence in patients with uterine cervical cancer.
Chung
Hyun Hoon
HH
Department of Obstetrics and Gynecology, Cancer Research Institute, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul 110-744, Republic of Korea.
Nam
Byung-Ho
BH
Kim
Jae Weon
JW
Kang
Keon Wook
KW
Park
Noh-Hyun
NH
Song
Yong-Sang
YS
Chung
June-Key
JK
Kang
Soon-Beom
SB
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001692:Biological Transport; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000378:metabolism*; D006801:Humans; D008875:Middle Aged; D049268:Positron-Emission Tomography; D057234:Preoperative Period; D011379:Prognosis; D012008:Recurrence; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000378:metabolism / Q000601:surgery*; D055815:Young Adult
D019788:Fluorodeoxyglucose F18