title: Prognostic significance of preoperative ¹⁸F-FDG PET/CT in uterine leiomyosarcoma.
abstract: OBJECTIVE
  Uterine leiomyosarcoma (LMS) is a rare and aggressive disease with poor outcome. Due to its rarity and conflict of data, investigation on finding prognostic factor is challenging. The aim of the study was to investigate the prognostic significance of preoperative ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) positron emission tomography/computed tomography (PET/CT) in uterine LMS.
  
  
  METHODS
  This was a retrospective observational cohort study in 3 tertiary referral hospitals. We retrospectively evaluated data from patients with pathologically proven uterine LMS who underwent preoperative ¹⁸F-FDG PET/CT scans at 3 institutions. The prognostic implication of PET/CT parameters and other clinico-pathological parameters on disease-free survival (DFS) and overall survival (OS) was evaluated.
  
  
  RESULTS
  Clinico-patholgical data were reviewed for 19 eligible patients. In the group overall, median DFS and OS were 12 and 20 months, respectively. As for the recurrence, large tumor size, and high tumor maximum standardized uptake value (SUVmax) were demonstrated as risk factors of recurrence. As for the OS, high tumor SUVmax was demonstrated as the unique risk factor. There were significant differences in tumor size, mitotic count, SUVmax, and DFS between patients with and without recurrence. Also, there were significant differences in tumor size, SUVmax, DFS, and OS between 2 subgroups stratified by cut-off SUVmax.
  
  
  CONCLUSIONS
  SUVmax at preoperative ¹⁸F-FDG PET/CT was associated with worse outcome in patients with uterine LMS. In the preoperative setting, SUVmax can be a valuable non-invasive prognostic marker. Additionally, SUVmax can help identify highly aggressive uterine LMS and may help in adjusting standard treatment toward an individualized, risk-adapted treatment.
authors.affiliation: Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Jeong Yeol
authors.identifier: http://orcid.org/0000-0003-2475-7123
authors.initials: JY
authors.lastname: Park
authors.affiliation: Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Jeong Won
authors.identifier: http://orcid.org/0000-0002-6945-0398
authors.initials: JW
authors.lastname: Lee
authors.affiliation: Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Hyun Ju
authors.initials: HJ
authors.lastname: Lee
authors.affiliation: Department of Nuclear Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Jong Jin
authors.initials: JJ
authors.lastname: Lee
authors.affiliation: Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Seung Hwan
authors.initials: SH
authors.lastname: Moon
authors.affiliation: Department of Nuclear Medicine, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Seo Young
authors.identifier: http://orcid.org/0000-0003-2431-3397
authors.initials: SY
authors.lastname: Kang
authors.affiliation: Department of Nuclear Medicine, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Gi Jeong
authors.identifier: http://orcid.org/0000-0002-1360-5186
authors.initials: GJ
authors.lastname: Cheon
authors.affiliation: Department of Obstetrics and Gynecology, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea. chhkmj@gmail.com.
authors.forename: Hyun Hoon
authors.identifier: http://orcid.org/0000-0002-5158-7492
authors.initials: HH
authors.lastname: Chung
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007890:Leiomyosarcoma / Q000000981:diagnostic imaging* / Q000473:pathology; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D000072078:Positron Emission Tomography Computed Tomography; D011237:Predictive Value of Tests; D057234:Preoperative Period; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D014594:Uterine Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: Fluorodeoxyglucose F18; Leiomyosarcoma; Positron Emission Tomography Computed Tomography; Prognosis; SUVmax; Uterine Diseases