TY - JOUR
T1 - Prognostic value of pretreatment metabolic pet parameters in cervical cancer patients with metabolic complete response after concurrent chemoradiotherapy
AU - Son, Seung Hyun
AU - Jeong, Shin Young
AU - Chong, Gun Oh
AU - Lee, Yoon Hee
AU - Park, Shin Hyung
AU - Lee, Chang Hee
AU - Hong, Chae Moon
AU - Jeong, Ju Hye
AU - Lee, Sang Woo
AU - Ahn, Byeong Cheol
AU - Lee, Jaetae
N1 - Publisher Copyright:
© 2018 Wolters Kluwer Health, Inc.
PY - 2018/9/1
Y1 - 2018/9/1
N2 - Purpose Cervical cancer may recur after concurrent chemoradiotherapy (CCRT), even in patients with metabolic complete response (mCR) on post-CCRT 18F-FDG PET. We retrospectively analyzed the value of metabolic parameters, measured by pretreatment PET, as prognostic factors for predicting recurrence and death in cervical cancer patients with mCR. Methods In 61 patients who reached mCR on post-CCRT, metabolic PET parameters including SUVmax, metabolic tumor volume (MTV), and total lesion glycolysis (TLG) of the primary tumors, as well as those of the metastatic lymph nodes, were measured by pre-CCRT PET. Total MTV and total TLG were also measured from primary tumors and metastatic lymph nodes. Survival analyses for disease-free survival (DFS) and overall survival (OS) were performed. Results Eleven patients (18.0%) presented with recurrence of cervical cancer, and 12 (19.7%) died during follow-up. SUVmax, MTV, TLG of metastatic lymph nodes, and total TLG could significantly predict DFS, and nodal SUVmax could predict OS. Para-aortic lymph node metastasis also significantly correlated with both DFS and OS. In multivariate analysis, nodal SUVmax and para-aortic lymph nodes metastasis were prognostic factors for DFS, and the best predictor was nodal SUVmax. For OS, nodal MTV and para-aortic lymph node metastasis were significant prognostic factors in multivariate analysis, and the best predictor was para-aortic lymph node metastasis. Conclusions Metabolic PET parameters, SUVmax or MTV values of metastatic lymph nodes, may be surrogate prognostic markers for recurrence or death in patients with locally advanced cervical cancer who reached mCR after definitive CCRT.
AB - Purpose Cervical cancer may recur after concurrent chemoradiotherapy (CCRT), even in patients with metabolic complete response (mCR) on post-CCRT 18F-FDG PET. We retrospectively analyzed the value of metabolic parameters, measured by pretreatment PET, as prognostic factors for predicting recurrence and death in cervical cancer patients with mCR. Methods In 61 patients who reached mCR on post-CCRT, metabolic PET parameters including SUVmax, metabolic tumor volume (MTV), and total lesion glycolysis (TLG) of the primary tumors, as well as those of the metastatic lymph nodes, were measured by pre-CCRT PET. Total MTV and total TLG were also measured from primary tumors and metastatic lymph nodes. Survival analyses for disease-free survival (DFS) and overall survival (OS) were performed. Results Eleven patients (18.0%) presented with recurrence of cervical cancer, and 12 (19.7%) died during follow-up. SUVmax, MTV, TLG of metastatic lymph nodes, and total TLG could significantly predict DFS, and nodal SUVmax could predict OS. Para-aortic lymph node metastasis also significantly correlated with both DFS and OS. In multivariate analysis, nodal SUVmax and para-aortic lymph nodes metastasis were prognostic factors for DFS, and the best predictor was nodal SUVmax. For OS, nodal MTV and para-aortic lymph node metastasis were significant prognostic factors in multivariate analysis, and the best predictor was para-aortic lymph node metastasis. Conclusions Metabolic PET parameters, SUVmax or MTV values of metastatic lymph nodes, may be surrogate prognostic markers for recurrence or death in patients with locally advanced cervical cancer who reached mCR after definitive CCRT.
KW - CCRT
KW - cervical cancer
KW - concurrent chemoradiotherapy
KW - metabolic complete response
KW - metabolic PET parameter
KW - prognosis
UR - http://www.scopus.com/inward/record.url?scp=85051842661&partnerID=8YFLogxK
U2 - 10.1097/RLU.0000000000002188
DO - 10.1097/RLU.0000000000002188
M3 - Article
C2 - 30036243
AN - SCOPUS:85051842661
SN - 0363-9762
VL - 43
SP - e296-e303
JO - Clinical Nuclear Medicine
JF - Clinical Nuclear Medicine
IS - 9
ER -