Introduction/Background Glucose metabolism has been suggested as a therapeutic target in ovarian clear cell carcinoma (CCC). We attempted to clarify 18F-FDG PET/CT-based metabolic metrics in the recurrent ovarian CCC patients and their prognostic values.
Methodology Quantitative metabolic parameters included maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV) and total lesion glycolysis (TLG). Two different methods were employed for defining the threshold SUV to delineate MTV: 1) SUV of 2.5 (designated as MTV); 2) a fixed ratio including 40% (MTV40), 50% (MTV50) and 60% (MTV60) of SUVmax. The Kaplan-Meier model and Cox regression were used in survival analysis.
Results Among the 35 patients, platinum-resistant recurrence accounted for 34.3% and the median progression-free survival was 13 months (range, 2–135). Fifteen (42.9%) patients presented with single tumor recurrence, while 51 recurrent lesions were identified, with the most common sites in pelvis (29.4%), followed by lymph node metastases (19.6%) and peritoneal carcinomatosis (15.7%). Except four patients with FDG-inavid tumor, the median SUVmax of the 31 patients with high glucose metabolic activity was 7.10 (range, 3.00–20.60). After a median follow-up of 36.5 months (range, 7–155), 22 patients (64.7%) were dead from disease. The median post-relapse survival (PRS) was 17 months (range, 4–126). High TLG60 level was associated with shorter overall survival (OS) (P=0.044) and PRS (P=0.031) on univariate analysis, while retained significance on multivariate analysis for OS (P=0.024).
Conclusion PET/CT-based metabolic volumetric parameters might be predicators for survival in recurrent ovarian CCC patients. More patients should be included in further study.
Disclosure The study was supported by grants from National Natural Science Foundation of China (81702558) and Fudan University Shanghai Cancer Center (YJ201603). The funding bodies didn´t participate in the design of the study and collection, analysis, and interpretation of data and in writing the manuscript. Shuang Ye declares that she has no competing interest. Shuai Liu Shuang Ye declares that she has no competing interest. Libing Xiang declares that he has no competing interest. Xiaohua Wu declares that he has no competing interest. Huijuan Yang declares that she has no competing interest.
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