The preoperative maximum standardized uptake value measured by 18F-FDG PET/CT as an independent prognostic factor of overall survival in endometrial cancer patients.
OBJECTIVE
The aim of this study was to determine if the preoperative maximum standardized uptake value (SUVmax) measured by 18F-FDG PET/CT in the primary tumor has prognostic value in the group of patients with endometrial cancer.


METHODS
A total of one hundred one consecutive endometrial cancer patients, age range 40-82 years (mean 62 years) and FIGO I-IV stage, who underwent 18-FDG-PET/CT within two weeks prior radical surgery, were enrolled to the study. The maximum SUV was measured and compared with the clinicopathologic features of surgical specimens. The relationship between SUVmax and overall survival was analyzed.


RESULTS
The mean preoperative SUVmax was 14.34; range (3.90-33.80) and was significantly lower for FIGO I than for higher stages (P = 0.0012), as well as for grade 1 than for grade 2 and 3 (P = 0.018), deep myometrial invasion (P = 0.0016) and for high risk group (P = 0.0004). The analysis of survival ROC curve revealed SUVmax cut-off value of 17.7 to predict high risk of recurrence. Endometrial cancer patients with SUVmax higher than 17.7 characterized by lower overall survival.


CONCLUSIONS
The preoperative SUVmax measured by 18F-FDG PET/CT is considered as an important indicator reflecting tumor aggressiveness which may predict poor prognosis. High value of SUVmax would be useful for making noninvasive diagnoses and deciding the appropriate therapeutic strategy for patients with endometrial cancer.
Department of Obstetrics and Gynecology, The Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University of Torun, Ujejskiego 75, 85-168 Bydgoszcz, Poland.
Malgorzata
0000-0001-7834-3466
M
Walentowicz-Sadlecka
Department of Nuclear Medicine, Lukaszczyk Oncology Center of Bydgoszcz, Poland.
Bogdan
B
Malkowski
Department of Obstetrics and Gynecology, The Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University of Torun, Ujejskiego 75, 85-168 Bydgoszcz, Poland.
Pawel
0000-0002-7748-343X
P
Walentowicz
Department of Obstetrics and Gynecology, The Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University of Torun, Ujejskiego 75, 85-168 Bydgoszcz, Poland.
Pawel
P
Sadlecki
Department of Clinical Pathology, The Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University of Torun, Poland.
Andrzej
A
Marszalek
Department of Nuclear Medicine, Lukaszczyk Oncology Center of Bydgoszcz, Poland.
Tomasz
T
Pietrzak
Department of Obstetrics and Gynecology, The Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University of Torun, Ujejskiego 75, 85-168 Bydgoszcz, Poland.
Marek
M
Grabiec
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D016889:Endometrial Neoplasms / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D011300:Preoperative Care; D011379:Prognosis; D014057:Tomography, X-Ray Computed
D019788:Fluorodeoxyglucose F18