Preoperative PET/CT standardized FDG uptake values of pelvic lymph nodes as a significant prognostic factor in patients with endometrial cancer.
OBJECTIVE
Using integrated PET/CT, we evaluated the prognostic relevance of preoperative pelvic lymph node (LN) (18)F-FDG uptake in endometrioid endometrial cancer.


METHODS
We retrospectively reviewed patients with pathologically proven endometrial cancer who underwent preoperative (18)F-FDG PET/CT scans to evaluate the prognostic significance of PET/CT parameters and other clinicopathological variables. We used Cox proportional hazards regression to examine the relationship between recurrence and the maximum standardized uptake value (SUVmax) in pelvic LNs (SUVLN) on FDG PET/CT.


RESULTS
Clinical data, treatment modalities and results were reviewed in 70 eligible patients. The median postsurgical follow-up was 29 months (range 6 to 95 months). Receiver-operating characteristic analysis identified the significant SUVLN cut-off value as 15. The SUVLN correlated with FIGO stage (P < 0.001), LN metastasis (P < 0.001), lymphovascular space invasion (P < 0.001), SUVtumour (P = 0.001), metastatic LN size (P = 0.004), primary tumour size (P = 0.012), tumour grade (P = 0.015) and depth of tumour invasion (P = 0.035). Regression analysis showed a statistically significant association between recurrence and SUVLN (P = 0.002). Recurrence differed significantly (P < 0.001) between patients with SUVLN >15 and those with SUVLN ≤15.


CONCLUSIONS
Preoperative pelvic LN FDG uptake exhibited a strong significant association with recurrence of endometrioid endometrial cancer.
Department of Obstetrics and Gynecology, Cancer Research Institute, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, Republic of Korea, chhkmj@gmail.com.
Hyun Hoon
HH
Chung
Gi Jeong
GJ
Cheon
Hee Seung
HS
Kim
Jae Weon
JW
Kim
Noh-Hyun
NH
Park
Yong Sang
YS
Song
D000328:Adult; D000368:Aged; D001692:Biological Transport; D016889:Endometrial Neoplasms / Q000175:diagnosis* / Q000378:metabolism / Q000601:surgery; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000378:metabolism; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000378:metabolism*; D008875:Middle Aged; D064847:Multimodal Imaging; D010388:Pelvis; D049268:Positron-Emission Tomography; D057234:Preoperative Period; D011379:Prognosis; D012008:Recurrence; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
D019788:Fluorodeoxyglucose F18