title: Prognostic impact of primary tumor SUVmaxon preoperative18F-fluoro-2-deoxy-D-glucose positron emission tomography and computed tomography in endometrial cancer and uterine carcinosarcoma.
abstract: The objective of the present study was to investigate the usefulness of the maximum standardized uptake value (SUVmax) of the primary tumor on preoperative18F-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography and computed tomography (PET/CT) as a prognostic indicator in patients with endometrial neoplasms. A total of 75 patients with endometrial cancer or uterine carcinosarcoma who underwent surgical treatment were included in the present study. All patients underwent preoperative PET/CT, and the correlation between the SUVmaxof the primary tumor and clinical outcomes was analyzed. The SUVmaxwas significantly higher in patients with stage II/III disease, a histology of grade 3 endometrioid adenocarcinoma and carcinosarcoma, a positive lymph node (LN) status, positive lymph-vascular space involvement (LVSI), and deep (≥1/2) myometrial invasion. Receiver operating characteristic curve analysis revealed that the optimal cut-off values of SUVmaxfor predicting a positive LN, LVSI and deep myometrial invasion were 7.49, 6.45 and 6.45, respectively. The overall survival (OS) and progression-free survival (PFS) of patients with a high SUVmaxwere significantly lower compared with those of patients with a low SUVmaxusing the cut-off value of 7.30. However, no significant difference was observed in the OS or PFS between the high and low SUVmaxgroups when analyzed in carcinosarcoma patients alone. Finally, multivariate analyses demonstrated that the SUVmaxof the primary tumor was an independent prognostic factor for impaired PFS in 55 endometrioid adenocarcinoma patients; however, not in all patients, including those with carcinosarcoma. The present findings demonstrated that the SUVmaxof the primary tumor may be a useful biomarker for predicting clinical outcomes of patients with endometrial cancer, although its prognostic impact appears to be limited in patients with uterine carcinosarcoma.
authors.affiliation: Department of Obstetrics and Gynecology, Wakayama Medical University, Wakayama 641-0012, Japan.
authors.forename: Tamaki
authors.initials: T
authors.lastname: Yahata
authors.affiliation: Department of Obstetrics and Gynecology, Wakayama Medical University, Wakayama 641-0012, Japan.
authors.forename: Shigetaka
authors.initials: S
authors.lastname: Yagi
authors.affiliation: Department of Obstetrics and Gynecology, Wakayama Medical University, Wakayama 641-0012, Japan.
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Mabuchi
authors.affiliation: Department of Obstetrics and Gynecology, Wakayama Medical University, Wakayama 641-0012, Japan.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Tanizaki
authors.affiliation: Department of Obstetrics and Gynecology, Wakayama Medical University, Wakayama 641-0012, Japan.
authors.forename: Aya
authors.initials: A
authors.lastname: Kobayashi
authors.affiliation: Department of Obstetrics and Gynecology, Wakayama Medical University, Wakayama 641-0012, Japan.
authors.forename: Madoka
authors.initials: M
authors.lastname: Yamamoto
authors.affiliation: Department of Obstetrics and Gynecology, Wakayama Medical University, Wakayama 641-0012, Japan.
authors.forename: Mika
authors.initials: M
authors.lastname: Mizoguchi
authors.affiliation: Department of Obstetrics and Gynecology, Wakayama Medical University, Wakayama 641-0012, Japan.
authors.forename: Sakiko
authors.initials: S
authors.lastname: Nanjo
authors.affiliation: Department of Obstetrics and Gynecology, Wakayama Medical University, Wakayama 641-0012, Japan.
authors.forename: Michihisa
authors.initials: M
authors.lastname: Shiro
authors.affiliation: Department of Obstetrics and Gynecology, Wakayama Medical University, Wakayama 641-0012, Japan.
authors.forename: Nami
authors.initials: N
authors.lastname: Ota
authors.affiliation: Department of Obstetrics and Gynecology, Wakayama Medical University, Wakayama 641-0012, Japan.
authors.forename: Sawako
authors.initials: S
authors.lastname: Minami
authors.affiliation: Wakayama Minami Radiology Clinic, Wakayama 641-0012, Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Terada
authors.affiliation: Department of Obstetrics and Gynecology, Wakayama Medical University, Wakayama 641-0012, Japan.
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Ino
keywords: FDG-PET/CT; SUVmax; carcinosarcoma; endometrial cancer; prognosis