Objective This study aims to ascertain if semiquantitative measurements derived from 18F-fluorodeoxyglucose positron emission tomography/computed tomography can be used as prognostic markers in patients with newly diagnosed endometrial cancer.
Materials and methods Patients with endometrial cancer and a preoperative 18F-fluorodeoxyglucose positron emission tomography/computed tomography before curatively intended treatment were included. The scans were evaluated using standard uptake values [maximum standard uptake value (SUVmax) and partial volume corrected (c) mean standardized uptake value (SUVmean)] and whole-body total lesion glycolysis (cTLG). All measurements were analyzed as prognostic factors in relation to overall survival (OS). Receiver operating characteristic curves were performed on all 3 positron emission tomography measurements to find the optimal cut-off for predicting OS. Multivariate Cox proportional regression models were used for prognostic evaluation.
Results Eighty-three patients (median age, 69.9 y; range, 26.8–91.1) with primarily high-risk endometrial cancer or suspected high The International Federation of Gynecology and Obstetrics stage were included. Mean follow-up time was 3.48 years (range, 0.31–6.87), and 24 patients died during follow-up. In multivariate analyses with adjustment for other known prognostic factors, a SUVmax of greater than or equal to 14.3 g/mL and cSUVmean of greater than or equal to 12.7 g/mL of the primary tumor yielded a hazard ratio for OS of 3.18 (1.19–8.49) and 1.93 (0.80–4.68), respectively. Whole-body cTLG of greater than or equal to 176.1 g yielded a hazard ratio of 5.70 (1.94–16.78) for OS in a multivariate analysis.
Conclusions Preoperative SUVmax and cTLG showed potential as independent prognostic markers of OS in patients with primarily high-risk endometrial cancer. Thus, SUVmax and cTLG might help identify patients who could benefit from a more aggressive treatment strategy or closer surveillance.
- Endometrial Cancer
- Semiquantitative Measurements
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This study received funding from Arvid Poulsens Familiefond. Grant was given for participation in European Association of Nuclear Medicine's 16th congress, October 2016.
There are no financial disclosures or conflict of interest from any author.