ATL. Issue 7 (1st September 2012)

• Record Type: Journal Article
• Authors: Yoo, Jang; Choi, Joon Young; Moon, Seung Hwan; Bae, Duk Soo; Park, Soo Bin; Choe, Yearn Seong; Lee, Kyung-Han; Kim, Byung-Tae
• Is Part Of: International journal of gynecological cancer. Volume 22:Issue 7(2012)
• Page Start: 1226
• Page End: 1233
• Publication Date: 2012-09-01
• Subjects: Uterine cervical cancer -- Prognosis -- 18F-FDG PET -- Metabolic tumor volume -- Total lesion glycolysis; Generative organs, Female -- Cancer -- Periodicals; 616.99465
• DOI: 10.1097/IGC.0b013e318260a905
• Languages: English
• ISSNs: 1048-891X

Abstract

Abstract : Objective: We compared the prognostic value of volume-based metabolic parameters determined using fluorine 18 ( 18 F) fluorodeoxyglucose (FDG) positron emission tomography (PET) ( 18 F-FDG PET) (with other prognostic parameters in uterine cervical cancer. Methods: The subjects were 73 female patients who had an initial diagnosis of uterine cervical cancer and who underwent 18 F-FDG PET. Various metabolic or volume-based PET parameters including maximum and average standardized uptake values, metabolic tumor volume, and total lesion glycolysis (TLG) were measured in primary cervical tumors. Survival analysis for disease-free survival or progression-free survival was performed with a Kaplan-Meier method using PET parameters and other clinical variables. For determining independent prognostic factors, Cox regression analysis was performed. Results: Recurrence or disease progression occurred in 23 patients (31.5%). In univariate analysis, patient age (cutoff, 57 years, P < 0.05), International Federation of Gynecology and Obstetrics stage ( P = 0.07), primary tumor size (cutoff, 6.7 cm; P < 0.05), lymph node status on PET ( P < 0.005), treatment method ( P < 0.01), metabolic tumor volume (cutoff, 82 cm 3 ; P = 0.001), and TLG (cutoff, 7600; P = 0.005) were significant predictors of recurrence or progression. In multivariate analysis, both lymph node status on PET (hazard ratio, 1.042 [negative vs intrapelvic metastasis only], 7.008 [negative vs extrapelvic metastasis]; P < 0.001) and TLG (cutoff, 7600; hazard ratio, 2.981; P < 0.05) were independent prognostic factors for predicting recurrence. Conclusions: In uterine cervical cancer, TLG, a volume-based metabolic parameter, and lymph node status on PET may be significant independent prognostic factors for event-free survival.