title: Prognostic value of total lesion glycolysis measured by 18F-FDG PET/CT in patients with locally advanced cervical cancer.
abstract: OBJECTIVE
  The aim of this study was to determine the most relevant parameters of fluorine-18 fluorodeoxyglucose (F-FDG) PET/computed tomography (CT) for predicting recurrence in patients with locally advanced cervical cancer.
  
  
  METHODS
  Fifty-six patients diagnosed with International Federation of Gynecology and Obstetrics (FIGO) stage IIB to IVA cervical cancer who underwent F-FDG PET/CT before definitive chemoradiotherapy were retrospectively enrolled. Various PET parameters, namely, maximum standardized uptake value, mean standardized uptake value, metabolic tumor volume, and total lesion glycolysis (TLG) of the primary tumor, were analyzed to evaluate the relationship between these PET parameters and recurrence-free survival (RFS). The cut-off values of PET parameters that showed the best trade-off between sensitivity and specificity for RFS were determined by receiver operating characteristic curve analysis.
  
  
  RESULTS
  The median follow-up was 20 months (range, 6-63 months). Univariate analysis indicated that higher FIGO stage [hazard ratio (HR) 5.606, 95% confidence interval (CI) 1.682-18.68, P=0.005], metabolic tumor volume more than 47.81 cm (HR 6.203, 95% CI 1.351-28.481, P=0.019), and TLG more than 215.02 (HR 11.817, 95% CI 1.518-91.963, P=0.018) were associated with RFS. In multivariate analysis, FIGO stage (HR 4.618, 95% CI 1.295-16.463, P=0.018) and TLG more than 215.02 (HR 10.171, 95% CI 1.246-83.044, P=0.030) were independent predictive factors for RFS. Kaplan-Meier curves for RFS indicated that patients with TLG less than or equal to 215.02 showed better RFS (P=0.003).
  
  
  CONCLUSIONS
  Pretreatment TLG proved to be an independent prognostic factor for RFS in patients with locally advanced cervical cancer treated by definitive chemoradiotherapy.
authors.affiliation: Departments of aObstetrics and Gynecology bNuclear Medicine, Guro Hospital cDepartment of Obstetrics and Gynecology, Ansan Hospital dDepartment of Nuclear Medicine, Anam Hospital, College of Medicine, Korea University eDepartment of Obstetrics and Gynecology, Hanyang University Guri Hospital, College of Medicine, Hanyang University, Seoul, Republic of Korea.
authors.forename: Jin Hwa
authors.initials: JH
authors.lastname: Hong
authors.forename: Un Suk
authors.initials: US
authors.lastname: Jung
authors.forename: Kyung Jin
authors.initials: KJ
authors.lastname: Min
authors.forename: Jae Kwan
authors.initials: JK
authors.lastname: Lee
authors.forename: Sungeun
authors.initials: S
authors.lastname: Kim
authors.forename: Jae Seon
authors.initials: JS
authors.lastname: Eo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D059248:Chemoradiotherapy; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics*; D006019:Glycolysis; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging* / Q000378:metabolism* / Q000517:prevention & control; D000072078:Positron Emission Tomography Computed Tomography / Q000379:methods; D011379:Prognosis; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics; D015203:Reproducibility of Results; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000000981:diagnostic imaging* / Q000378:metabolism* / Q000628:therapy
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18