Pretreatment [18F]FDG PET/CT Prognostic Factors in Patients with Squamous Cell Cervical Carcinoma FIGO IIIC1

Abstract

Purpose: This study aims to determine whether semiquantitative parameters obtained from both the primary tumor and metastatic pelvic lymph nodes (PLN) diagnosed in fluoro-18-deoxy-glucose positron emission tomography (FDG-PET-CT) are associated with disease-free survival (DFS), local control (LC), distant metastasis-free survival (DMFS) and overall survival (OS) in patients with locally advanced squamous cervical cancer (LACC) and metastatic pelvic lymph nodes. Materials: Retrospective analysis was performed on 93 female patients with FIGO IIIC1. The median age was 53 years (27–75). The PET parameters both in the primary tumor and metastatic pelvic lymph nodes, including SUVmax, SUVmean, TLG, MTV, heterogeneity, along with clinical variables, before radical cisplatin-based radiochemotherapy (RCT) were analyzed. The p-values < 0.05 were considered statistically significant. Results: Median follow-up was 38 months (4.5–92.6). Three years and five years OS were 75% and 70% respectively. Patients with SUVmax above 12.6, SUVmean above 7.6 and with TLG in tumors >245.7 lived longer (p < 0.05). The higher SUVmax or SUVmean reduced increased DMFS (HR 0.3 95%CI 0.56–0.96 and 0.59 95%CI 0.37–0.93). The clinical factors and other FDG PET CT parameters were not found to be statistically relevant in terms of OS, DFS, DM and LC. Conclusions: This study is the first report showing that in LACC patient population with PLN involvement treated with definitive RCT, high SUVmean, SUVmax and TLG of the primary tumor in FDG-PET-CT were linked with longer OS. Lower SUVmean and SUVmax were linked with shorter DMFS. None of the clinical factors and the nodal FDG-PET-CT parameters influenced the outcome.

Improving effectiveness using nimotuzumab (NTZ) in patients with nasopharyngeal carcinoma based on the 18F-FDG PET/CT maximum standardized uptake value

“…In another retrospective study G.D Di Stasio et.al revealed that SUVmax ≥10.08, MTV ≥27.89, and TLG ≥134.85 conferred a significantly worse prognosis in 49 patients with pleomorphic lung carcinoma, and that the metabolic biomarkers mentioned above could be used to predict recurrence and death [29]. Ewa Burchardt et.al, in a multivariate COX regression analysis of 93 locally advanced squamous cervical cancer patients who received radical cisplatin-based chemoradiotherapy, found that SUVmax above 12.6 and TLG above 245.7 were independent predictors of OS [30]. Lin Ching Chan et al studied 108 patients with NPC receiving chemoradiotherapy and found that a pretreatment SUV >8.35 could lead to a significantly worse 3-year OS compared to a lower SUV value.…”

Improving effectiveness using nimotuzumab in patients with nasopharyngeal carcinoma based on the 18F-FDG PET/CT maximum standardized uptake value

“…In another retrospective study G.D Di Stasio et.al revealed that SUVmax ≥ 10.08, MTV ≥ 27.89, and TLG ≥ 134.85 conferred a signi cantly worse prognosis in 49 patients with pleomorphic lung carcinoma, and that the metabolic biomarkers mentioned above could be used to predict recurrence and death [29]. Ewa Burchardt et.al, in a multivariate COX regression analysis of 93 locally advanced squamous cervical cancer patients who received radical cisplatin-based chemoradiotherapy, found that SUVmax above 12.6 and TLG above 245.7 were independent predictors of OS [30]. Lin Ching Chan et al studied 108 patients with NPC receiving chemoradiotherapy and found that a pretreatment SUV > 8.35 could lead to a signi cantly worse 3-year OS compared to a lower SUV value.…”