The value of PET/CT for cytoreductive surgery selection in recurrent ovarian carcinoma

• Published in: Journal of gynecologic oncology 2023, 34(3), , pp.1-12
• Main Authors: Nunes, Rafael Leite, Teixeira, Flávio Rodrigues, Diniz, Thiago Pereira, Faloppa, Carlos Chaves, Mantoan, Henrique, da Costa, Alexandre Andre Balieiro Anastacio, Baiocchi, Glauco
• Format: Article
• Language: English
• Subjects: Carcinoma, Ovarian Epithelial; Chronic Disease; Cytoreduction Surgical Procedures - methods; Female; Fluorodeoxyglucose F18; Humans; Neoplasm Recurrence, Local - pathology; Original; Ovarian Neoplasms - diagnostic imaging; Ovarian Neoplasms - pathology; Ovarian Neoplasms - surgery; Positron Emission Tomography Computed Tomography; Positron-Emission Tomography - methods; Radiopharmaceuticals; Retrospective Studies; 산부인과학
• ISSN: 2005-0380; 2005-0399
• DOI: 10.3802/jgo.2023.34.e31

To evaluate the value of positron emission tomography/computed tomography (PET/CT) in predicting no residual disease (NRD) after secondary cytoreductive surgery (SCS) compared with MSK criteria, the iMODEL, and the AGO score. We analyzed 112 patients with platinum-sensitive ovarian carcinoma who underwent SCS. We excluded patients for whom PET/CT was not performed, those without sufficient data, and who received chemotherapy before SCS. Ultimately, 69 patients were included. Variables that correlated with NRD were peritoneal carcinomatosis index (odds ratio [OR]=0.91; 95% confidence interval [CI]=0.83-0.99; p=0.044), European Cooperative Oncology Group Performance Status (ECOG) 0 (OR=8.0; 95% CI=1.34-47.5; p=0.022), and ≤2 lesions by PET/CT (OR=4.36; 95% CI=1.07-17.7; p=0.039). Of the patients with ≤2 lesions by PET/CT, 48 (92.3%) underwent complete SCS. The sensitivity, positive predictive value, negative predictive value, and accuracy of PET/CT for NRD were 85.7%, 92.3%, 33.3%, and 81.2%, respectively. NRD was achieved after fulfilling the MSK criteria, iMODEL and AGO Score in 89.1%, 88.1% and 85.9%, respectively. The accuracy of the MSK criteria, iMODEL, and AGO score in predicting NRD was 87%, 83.3%, and 77.3%, respectively. The PET/CT findings agreed well with the AGO score and iMODEL. The addition of PET/CT to these models increased the NRD rates (92.2%, 91.8%, and 89.4% for MSK+PET/CT, iMODEL+PET/CT, and AGO+PET/CT, respectively), but lowered their accuracy. We observed NRD in 92.3% of patients with ≤2 lesions by PET/CT, with an accuracy of 81.2%. PET/CT did not increase the accuracy of the MSK criteria, iMODEL, or AGO score models.