Prognostic impact of primary tumor [SUV.sub.max] on preoperative [sup.18]F-fluoro-2-deoxy-D-glucose positron emission tomography and computed tomography in endometrial cancer and uterine carcinosarcoma

• Published in: Molecular and clinical oncology 2016-10, p.467
• Main Authors: Yahata, Tamaki, Yagi, Shigetaka, Mabuchi, Yasushi, Tanizaki, Yuko, Kobayashi, Aya, Yamamoto, Madoka, Mizoguchi, Mika, Nanjo, Sakiko, Shiro, Michihisa, Ota, Nami, Minami, Sawako, Terada, Masaki, Ino, Kazuhiko
• Format: Article
• Language: English
• Subjects: CT imaging; Endometrial cancer; Evaluation; Patient outcomes; PET imaging; Preoperative care
• ISSN: 2049-9450
• DOI: 10.3892/mco.2016.980

The objective of the present study was to investigate the usefulness of the maximum standardized uptake value ([SUV.sub.max]) of the primary tumor on preoperative [sup.18]F-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography and computed tomography (PET/CT) as a prognostic indicator in patients with endometrial neoplasms. A total of 75 patients with endometrial cancer or uterine carcinosarcoma who underwent surgical treatment were included in the present study. All patients underwent preoperative PET/CT, and the correlation between the [SUV.sub.max] of the primary tumor and clinical outcomes was analyzed. The [SUV.sub.max] was significantly higher in patients with stage II/ III disease, a histology of grade 3 endometrioid adenocarcinoma and carcinosarcoma, a positive lymph node (LN) status, positive lymph-vascular space involvement (LVSI), and deep ([greater than or equal to]1/2) myometrial invasion. Receiver operating characteristic curve analysis revealed that the optimal cut-off values of [SUV.sub.max] for predicting a positive LN, LVSI and deep myometrial invasion were 7.49, 6.45 and 6.45, respectively. The overall survival (OS) and progression-free survival (PFS) of patients with a high [SUV.sub.max] were significantly lower compared with those of patients with a low [SUV.sub.max] using the cut-off value of 7.30. However, no significant difference was observed in the OS or PFS between the high and low [SUV.sub.max] groups when analyzed in carcinosarcoma patients alone. Finally, multivariate analyses demonstrated that the [SUV.sub.max] of the primary tumor was an independent prognostic factor for impaired PFS in 55 endometrioid adenocarcinoma patients; however, not in all patients, including those with carcinosarcoma. The present findings demonstrated that the [SUV.sub.max] of the primary tumor may be a useful biomarker for predicting clinical outcomes of patients with endometrial cancer, although its prognostic impact appears to be limited in patients with uterine carcinosarcoma. Key words: FDG-PET/CT, [SUV.sub.max], endometrial cancer, carcinosarcoma, prognosis