TY - JOUR T1 - Positron Emission Tomography/Computed Tomography Predictors of Overall Survival in Stage IIIC/IV Ovarian Cancer JF - International Journal of Gynecologic Cancer JO - Int J Gynecol Cancer SP - 1163 LP - 1169 DO - 10.1097/IGC.0b013e3182606ecb VL - 22 IS - 7 AU - Signe Risum AU - Annika Loft AU - Svend Aage Engelholm AU - Estrid Høgdall AU - Anne Kiil Berthelsen AU - Lotte Nedergaard AU - Lene Lundvall AU - Claus Høgdall Y1 - 2012/09/01 UR - http://ijgc.bmj.com/content/22/7/1163.abstract N2 - Objective To evaluate the role of 2-deoxy-2-(18F)fluoro-D-glucose (FDG) positron emission tomography/computed tomography (PET/CT) for selecting patients with extensive ovarian cancer (OC) for neoadjuvant chemotherapy by evaluating predictors of overall survival in patients with stage IIIC/IV OC.Materials and Methods From September 1, 2004, to November 20, 2011, 514 consecutive patients with a pelvic tumor underwent preoperative PET/CT; 179 patients had stage IIIC/IV OC. Patients’ characteristics were collected from 153 patients with stage IIIC/IV OC who underwent primary surgery. In 152 patients with stage IIIC/IV OC, clinical predictors and PET/CT predictors of survival were evaluated.Results Median age was 64 years (range, 38–88 years); 87% (113) of the 153 patients had a performance status of less than 2; 55% (84) of the 153 patients had PET/CT stage III, and 45% (69) of the 153 patients had PET/CT stage IV. Using univariate analysis, incomplete debulking (P = 0.0001), pleural exudates (P = 0.001), postmenopausal state (P = 0.01), WHO performance status greater than 2 (P = 0.01), PET/CT stage IV (P = 0.01), and large bowel mesentery implants (P = 0.02) were statistically significant prognostic variables. Using multivariate Cox regression analysis, incomplete debulking was the only statistically significant independent prognostic variable (P = 0.0001). Median overall survival was significantly longer in the 53 patients with no residual tumor than in the 99 patients with residual tumor (33.3 vs 25.5 months; P = 0.0001)Conclusion Suggested PET/CT criteria for referral of patients with advanced OC to neoadjuvant chemotherapy are PET/CT stage IV, pleural exudates, and PET-positive large bowel mesentery implants. Evaluation of selection criteria for neoadjuvant chemotherapy should be promoted in prospective clinical trials, with survival as the primary end point. ER -