title: Metabolic tumour volume and total lesion glycolysis, measured using preoperative 18F-FDG PET/CT, predict the recurrence of endometrial cancer.
abstract: OBJECTIVE
  To investigate the prognostic value of metabolic tumour volume (MTV) and total lesion glycolysis (TLG), measured by preoperative positron emission tomography and computerised tomography (PET/CT), in women with endometrial cancer.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  A tertiary referral centre.
  
  
  METHODS
  Women with endometrial cancer who underwent preoperative (18)F-FDG PET/CT in the period 2004-2009.
  
  
  METHODS
  Clinicopathological data for 84 women with endometrial cancer were reviewed from medical records. Cox proportional hazards modelling identified recurrence predictors. The receiver operating characteristic (ROC) curve was used to determine the cut-off value for predicting recurrence.
  
  
  METHODS
  Disease-free survival (DFS).
  
  
  RESULTS
  The number of patients with International Federation of Gynecology and Obstetrics (FIGO) stages were: I (58); II (11); III (13); and IV (2). The median DFS was 48 (1-85) months. By univariate analysis, DFS was significantly associated with FIGO stage, histology, peritoneal cytology, myometrial invasion, nodal metastasis, serum CA-125, MTV, and TLG. Using multivariate analysis, the MTV (P = 0.010; hazard ratio, HR = 1.010; 95% confidence interval, 95% CI = 1.002-1.018) and TLG (P = 0.024; HR = 1.001; 95% CI = 1.000-1.002) were associated with DFS. The area under the ROC curve was 0.679 (95% CI = 0.505-0.836) after discriminating for recurrence using an MTV cut-off value of 17.15 ml. Regarding TLG, the cut-off value was 56.43 g and the area under the ROC plot was 0.661 (95% CI = 0.501-0.827). Kaplan-Meier survival graphs demonstrated a significant difference in DFS between groups categorised using the cut-off values for MTV and TLG (P < 0.022 for MTV and P < 0.047 for TLG, by log-rank test).
  
  
  CONCLUSIONS
  Preoperative MTV and TLG could be independent prognostic factors predicting the recurrence of endometrial cancer.
authors.affiliation: Department of Obstetrics and Gynaecology, School of Medicine, Konkuk University, Seoul, Korea.
authors.forename: S-H
authors.initials: SH
authors.lastname: Shim
authors.forename: D-Y
authors.initials: DY
authors.lastname: Kim
authors.forename: D-Y
authors.initials: DY
authors.lastname: Lee
authors.forename: S-W
authors.initials: SW
authors.lastname: Lee
authors.forename: J-Y
authors.initials: JY
authors.lastname: Park
authors.forename: J J
authors.initials: JJ
authors.lastname: Lee
authors.forename: J-H
authors.initials: JH
authors.lastname: Kim
authors.forename: Y-M
authors.initials: YM
authors.lastname: Kim
authors.forename: Y-T
authors.initials: YT
authors.lastname: Kim
authors.forename: J-H
authors.initials: JH
authors.lastname: Nam
mesh_terms: D000328:Adult; D000368:Aged; D018572:Disease-Free Survival; D016889:Endometrial Neoplasms / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology; D005260:Female; D019788:Fluorodeoxyglucose F18; D006019:Glycolysis; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis*; D049268:Positron-Emission Tomography / Q000379:methods; D011300:Preoperative Care / Q000379:methods; D011379:Prognosis; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods; D055815:Young Adult
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: Endometrial cancer; metabolic tumour volume; positron emission tomography/computed tomography; total lesion glycolysis