title: Clinical and Survival Impact of FDG PET in Patients with Suspicion of Recurrent Ovarian Cancer: A 6-Year Follow-Up.
abstract: BACKGROUND
  The aim of this retrospective study was to evaluate the contribution of fluorine-18-fluoro-deoxyglucose (FDG) positron emission tomography (PET) to the clinical management and survival outcome of patients (pts) suspected of recurrent ovarian carcinoma, with the hypothesis that early diagnosis of recurrent ovarian cancer may improve overall survival (OS).
  
  
  METHODS
  Fifty-three FDG PET/CT scans were retrospectively analyzed for 42 pts. CT and PET/CT findings were confirmed by imaging and clinical follow-up, and/or pathology, which were considered as the gold standard diagnosis. The treatment plan based on CT staging was compared with that based on PET/CT findings. Medical records were reviewed for pts characteristics, progression-free survival (PFS), and OS. PFS and OS were analyzed using the Cox proportional hazards regression model.
  
  
  RESULTS
  The final diagnosis of recurrence was established pathologically (n = 16), or by a median clinical follow-up of 6.5 years (range 0.5-7.5) after the PET/CT (n = 37). PET/CT provided a higher detection sensitivity (92.2%, 47/51) than CT (60.8%, 31/51) (p < 0.001). Globally, PET/CT modified the treatment plan in 56.6% (30/53) and in 65.2% (15/23) when the CT was negative prior to PET/CT. In 30 cases, those benefited from a modified treatment plan, these changes led to the intensification of a previous treatment procedure in 83.3% (25/30), and to a reduction in the previous treatment procedure in 16.6% of cases (5/30). The Cox regression multivariate analysis showed that the number of lesions visualized by CT and presence of lung lesions detected by PET/CT were significantly associated with PFS (p = 0.002 and p = 0.035, respectively).
  
  
  CONCLUSIONS
  On account of its impact on treatment planning, and especially in predicting patient outcome, FDG PET is a valuable diagnostic tool for cases of suspected ovarian cancer recurrence.
authors.affiliation: Nuclear Medicine Unit, ICO Cancer Center , Saint-Herblain , France.
authors.forename: Daniela
authors.initials: D
authors.lastname: Rusu
authors.affiliation: CNRS UMR 6299, Centre Régional de Recherche en Cancérologie Nantes-Angers (CRCNA), INSERM U892 , Nantes , France ; Nuclear Medicine, University Hospital Nantes , Nantes , France.
authors.forename: Thomas
authors.initials: T
authors.lastname: Carlier
authors.affiliation: Nuclear Medicine Unit, ICO Cancer Center , Saint-Herblain , France ; CNRS UMR 6299, Centre Régional de Recherche en Cancérologie Nantes-Angers (CRCNA), INSERM U892 , Nantes , France.
authors.forename: Mathilde
authors.initials: M
authors.lastname: Colombié
authors.affiliation: Nuclear Medicine Unit, ICO Cancer Center , Saint-Herblain , France.
authors.forename: Dorothée
authors.initials: D
authors.lastname: Goulon
authors.affiliation: Nuclear Medicine Unit, ICO Cancer Center , Saint-Herblain , France.
authors.forename: Vincent
authors.initials: V
authors.lastname: Fleury
authors.affiliation: Nuclear Medicine Unit, ICO Cancer Center , Saint-Herblain , France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Rousseau
authors.affiliation: Oncology Unit, ICO Cancer Center , Saint-Herblain , France.
authors.forename: Dominique
authors.initials: D
authors.lastname: Berton-Rigaud
authors.affiliation: Oncologic Surgery Unit, ICO Cancer Center , Saint-Herblain , France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Jaffre
authors.affiliation: Nuclear Medicine Unit, ICO Cancer Center , Saint-Herblain , France ; CNRS UMR 6299, Centre Régional de Recherche en Cancérologie Nantes-Angers (CRCNA), INSERM U892 , Nantes , France ; Nuclear Medicine, University Hospital Nantes , Nantes , France.
authors.forename: Françoise
authors.initials: F
authors.lastname: Kraeber-Bodéré
authors.affiliation: CNRS UMR 6299, Centre Régional de Recherche en Cancérologie Nantes-Angers (CRCNA), INSERM U892 , Nantes , France ; Statistics Unit, ICO Cancer Center , Saint-Herblain , France.
authors.forename: Loic
authors.initials: L
authors.lastname: Campion
authors.affiliation: Nuclear Medicine Unit, ICO Cancer Center , Saint-Herblain , France ; CNRS UMR 6299, Centre Régional de Recherche en Cancérologie Nantes-Angers (CRCNA), INSERM U892 , Nantes , France.
authors.forename: Caroline
authors.initials: C
authors.lastname: Rousseau
keywords: 18F-FDG; PET/CT; ovarian cancer; recurrence; survival outcome