title: Primary tumor SUVmaxon preoperative FDG-PET/CT is a prognostic indicator in stage IA2-IIB cervical cancer patients treated with radical hysterectomy.
abstract: The objective of the present study was to investigate the prognostic value of18F-fluoro-2-deoxy-D-glucose (FDG) uptake by primary tumors on positron emission tomography/computed tomography (PET/CT) in surgically resectable cervical cancer. A total of 59 patients with stage IA2-IIB cervical cancer who underwent preoperative FDG-PET/CT, followed by radical hysterectomy and lymphadenectomy, were included in the study. The maximum standardized uptake value (SUVmax) of the primary tumor was measured, and the association between the SUVmaxand clinicopathological factors or patient outcomes was analyzed. The SUVmaxwas significantly higher in patients with an advanced stage, lymph node metastasis, lymph-vascular space involvement and large tumors. The overall survival (OS) and progression-free survival (PFS) of patients with a high SUVmaxwere significantly lower compared with patients with a low SUVmax, using an optimal cut-off value of 7.36 for OS and 5.59 for PFS obtained from receiver operating characteristic curve analysis. Similarly, OS and PFS in patients with a high SUVmaxwere significantly lower in 39 patients with stage IB using a cut-off value of 7.90 and 6.69 for OS and PFS, respectively. Finally, multivariate analyses showed that the SUVmaxof the primary tumor was an independent prognostic factor for impaired PFS in all patients and those with stage IB alone. These findings demonstrated that a high SUVmaxon preoperative PET/CT was correlated with unfavorable clinical outcomes in patients receiving radical hysterectomy, suggesting that the SUVmaxof the primary tumor may be a prognostic indicator for surgically-treated, early-stage invasive cervical cancer.
authors: Department of Obstetrics and Gynecology, Wakayama Medical University, Wakayama 641-0012, Japan.
authors: Shigetaka
authors: S
authors: Yagi
authors: Department of Obstetrics and Gynecology, Wakayama Medical University, Wakayama 641-0012, Japan.
authors: Tamaki
authors: T
authors: Yahata
authors: Department of Obstetrics and Gynecology, Wakayama Medical University, Wakayama 641-0012, Japan.
authors: Yasushi
authors: Y
authors: Mabuchi
authors: Department of Obstetrics and Gynecology, Wakayama Medical University, Wakayama 641-0012, Japan.
authors: Yuko
authors: Y
authors: Tanizaki
authors: Department of Obstetrics and Gynecology, Wakayama Medical University, Wakayama 641-0012, Japan.
authors: Aya
authors: A
authors: Kobayashi
authors: Department of Obstetrics and Gynecology, Wakayama Medical University, Wakayama 641-0012, Japan.
authors: Michihisa
authors: M
authors: Shiro
authors: Department of Obstetrics and Gynecology, Wakayama Medical University, Wakayama 641-0012, Japan.
authors: Nami
authors: N
authors: Ota
authors: Department of Obstetrics and Gynecology, Wakayama Medical University, Wakayama 641-0012, Japan.
authors: Sawako
authors: S
authors: Minami
authors: Wakayama Minami Radiology Clinic, Wakayama 641-0012, Japan.
authors: Masaki
authors: M
authors: Terada
authors: Department of Obstetrics and Gynecology, Wakayama Medical University, Wakayama 641-0012, Japan.
authors: Kazuhiko
authors: K
authors: Ino
keywords: cervical cancer; maximum standardized uptake value; positron emission tomography/computed tomography; prognosis; radical hysterectomy