Prognostic Value of Pretreatment 18F-fluorodeoxyglucose Uptake in Patients With Cervical Cancer Treated With Definitive Chemoradiotherapy

Onal, Cem; Reyhan, Mehmet; Parlak, Eda; Güler, Ozan Cem; Oymak, Ezgi

doi:10.1097/igc.0b013e3182989483

Cited by 54 publications

(35 citation statements)

References 29 publications

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“…Several reports have suggested that locally advanced cervical cancers in which the primary tumors show high F-18 FDG uptake are associated with a poorer prognosis than cervical cancers with low uptake [10,20]. Recently, a few studies have demonstrated that regional lymph node F-18 FDG uptake might be a prognostic biomarker in patients with cervical cancer who are treated with CCRT [11][12][13].…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have demonstrated that the maximum standardized uptake value (SUVmax) and metabolic parameters of the primary tumor correlated with lymph node metastasis, persistent disease after treatment, pelvic disease recurrence, and poor overall survival (OS) [9,10]. Moreover, recent studies have reported that a high SUVmax of the regional lymph nodes is a significant adverse factor in patients with cervical cancer [11][12][13].…”

Section: Introductionmentioning

confidence: 99%

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Comparison of the prognostic value of F-18 PET metabolic parameters of primary tumors and regional lymph nodes in patients with locally advanced cervical cancer who are treated with concurrent chemoradiotherapy

Chong

Lee

Hong

et al. 2016

Gynecologic Oncology

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ObjectiveThis study investigated the metabolic parameters of primary tumors and regional lymph nodes, as measured by pre-treatment F-18 fluorodeoxyglucose positron emission tomography/computed tomography (F-18 FDG PET/CT) to compare the prognostic value for the prediction of tumor recurrence. This study also identified the most powerful parameter in patients with locally advanced cervical cancer treated with concurrent chemoradiotherapy. MethodsFifty-six patients who were diagnosed with cervical cancer with pelvic and/or paraaortic lymph node metastasis were enrolled in this study. Metabolic parameters including the maximum standardized uptake value (SUVmax), the metabolic tumor volume (MTV), and total lesion glycolysis (TLG) of the primary tumors and lymph nodes were measured by pre-treatment F-18 FDG PET/CT. Univariate and multivariate analyses for disease-free survival (DFS) were performed using the clinical and metabolic parameters. ResultsThe metabolic parameters of the primary tumors were not associated with DFS. However, DFS was significantly longer in patients with low values of nodal metabolic parameters than in those with high values of nodal metabolic parameters. A univariate analysis revealed that nodal metabolic parameters (SUVmax, MTV and TLG), paraaortic lymph node metastasis, and post-treatment response correlated significantly with DFS. Among these parameters, nodal SUVmax (hazard ratio [HR], 4.158; 95% confidence interval [CI], 1.1-22.7; p = 0.041) PLOS ONE |

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Comparison of the prognostic value of F-18 PET metabolic parameters of primary tumors and regional lymph nodes in patients with locally advanced cervical cancer who are treated with concurrent chemoradiotherapy

Chong

Lee

Hong

et al. 2016

Gynecologic Oncology

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“…It has been illustrated that standardized uptake value (SUV) on 18 F-FDG PET/CT might be significantly associated with prognosis [5,6]. However, results from previous studies are controversial due to limited sample size.…”

Section: Introductionmentioning

confidence: 89%

“…We analyzed 58 studies in full text, and 45 of them were excluded; the reasons for exclusion are listed in figure 1. Consequently, a total of 1,196 patients from 13 trials [5,6,11,12,13,14,15,16,17,18,19,20,21] were entered into the meta-analysis.…”

Section: Resultsmentioning

confidence: 99%

Standardized Uptake Value on <sup>18</sup>F-FDG PET/CT as a Prognostic Factor for Survival of Women with Malignant Uterine Tumors: A Meta-Analysis

Pan

Yao²,

Ma³

2015

Gynecol Obstet Invest

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Background: Malignant uterine tumors are crucial in the evaluation of prognosis and the determination of therapeutic strategy. Aim: This meta-analysis of the available literature aimed to investigate the prognostic value of standardized uptake value (SUV) on fluorine-18-fluorodeoxyglucose positron emission tomography with computed tomography (¹⁸F-FDG PET/CT) in uterine malignancies before treatment. Methods: The PubMed, MEDLINE and EMBASE databases (1990 to February 2014) were searched to identify studies evaluating SUV on ¹⁸F-FDG PET/CT as a prognostic tool for predicting long-term survival in patients with carcinomas of the uterus. The χ² test and the I² index were used to estimate heterogeneity among the trials selected in the meta-analysis. The combined hazard ratio was calculated by using a fixed- or random-effects model according to heterogeneity. Results: Thirteen studies with a total of 1,196 patients were eligible for analysis. High pretreatment SUV_max was significantly associated with poorer event-free survival and overall survival, and the summarized hazard ratio was 3.33 (95% confidence interval 2.34-4.74) and 1.31 (95% confidence interval 1.03-1.67), respectively. Conclusion: The present evidence indicates that SUV on ¹⁸F-FDG PET/CT seems to be a valuable prognostic indicator for survival of patients with malignant uterine tumors. Given that ¹⁸F-FDG PET/CT can provide both morphologic and functional information, we suggest utilizing PET/CT and its quantitative marker in uterine malignancies before treatment.

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“…The treatment of choice for locally advanced cervical cancer is definitive chemoradiotherapy (CRT), resulting in a 5-year overall survival of 70% and a 5-year local failure rate of 20-30%. 5,7,8 The incidence of distant metastasis is 12-15%, depending on the study, and treatment strategies include systemic chemotherapy (ChT) and palliative radiotherapy (RT) in certain cases. 7 Carcinoma of the cervix usually spreads in an orderly and predictable fashion.…”

Section: Fig 3 -(A) Histopathological Appearance Of the Jejunum [Hemmentioning

Prognostic Value of Pretreatment 18F-fluorodeoxyglucose Uptake in Patients With Cervical Cancer Treated With Definitive Chemoradiotherapy

Abstract: The primary tumor pretreatment SUVmax is correlated with increased tumor size and lymph node involvement at diagnosis, how well the primary tumor responds to treatment, the likelihood of disease recurrence, and OS.

Cited by 54 publications

References 29 publications

Comparison of the prognostic value of F-18 PET metabolic parameters of primary tumors and regional lymph nodes in patients with locally advanced cervical cancer who are treated with concurrent chemoradiotherapy

Comparison of the prognostic value of F-18 PET metabolic parameters of primary tumors and regional lymph nodes in patients with locally advanced cervical cancer who are treated with concurrent chemoradiotherapy

Standardized Uptake Value on <sup>18</sup>F-FDG PET/CT as a Prognostic Factor for Survival of Women with Malignant Uterine Tumors: A Meta-Analysis

Isolated jejunal metastasis in a patient with cervical cancer: A case report

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