Post-treatment [¹⁸F]FDG maximum standardized uptake value as a prognostic marker of recurrence in endometrial carcinoma.
OBJECTIVE
The purpose of this study was to determine whether post-treatment [(18)F]fluorodeoxyglucose (FDG) uptake measured as the maximum standardized uptake value (SUV(max)) by integrated positron emission tomography (PET)/computed tomography (CT) imaging has prognostic significance in patients with endometrial carcinoma.


METHODS
Patients previously treated by primary surgical staging for endometrial carcinoma were imaged with integrated FDG PET/CT during surveillance. PET/CT findings were compared with histological or clinical evaluation, and the relationship between SUV(max) on PET/CT and recurrence was examined.


RESULTS
A total of 61 patients were eligible for analysis. Medical records were retrospectively reviewed for clinical data, treatment modalities and outcome. The median duration of follow-up was 31 months (range 6-102 months) post-treatment. SUV(max) levels were inversely associated with disease-free survival (DFS). Patients were divided into two groups according to SUV(max) (< 4.25 versus ≥ 4.25). The Kaplan-Meier survival graph showed a significant difference in DFS between groups [p < 0.001, hazard ratio (HR) 12.959, 95% confidence interval (CI) 3.650-46.011]. In multivariate analyses, post-treatment SUV(max) (uncategorized values) evaluated by surveillance PET/CT (p = 0.001, HR 1.199, 95% CI 1.077-1.334) and serous adenocarcinoma histology (p = 0.028, HR 5.594, 95% CI 1.207-25.931) were significantly associated with recurrence.


CONCLUSIONS
Post-treatment FDG uptake as measured by SUV(max) showed a significant association with recurrence in patients with endometrial carcinoma and may be used as a new useful prognostic marker.
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.
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; D018572:Disease-Free Survival; D016889:Endometrial Neoplasms / Q000175:diagnosis* / Q000378:metabolism* / Q000628:therapy; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000378:metabolism*; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D049268:Positron-Emission Tomography; D012008:Recurrence; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
D019788:Fluorodeoxyglucose F18