Prognostic Value of Volume-Based Metabolic Parameters Obtained by 18F-FDG–PET/CT in Patients With Locally Advanced Squamous Cell Cervical Carcinoma

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Abstract

Objective

The aim of the study was to assess the prognostic impact of volume-based metabolic 18F-fluorodeoxyglucose–positron emission tomography/ computed tomography (18F-FDG–PET/CT) parameters in patients with stage IB–IVA squamous cell cervical carcinoma (SCCC).

Materials and Methods

We reviewed the pretreatment 18F-FDG–PET/CT records of 67 patients with stage IB–IVA SCCC. The maximum standardized uptake value (SUVmax) of the primary tumor (PSUVmax), highest SUVmax of the whole malignant lesions (WSUVmax), metabolic tumor volume (MTV) of the primary tumor (PMTV), MTV of the whole malignant lesion (WMTV), total lesion glycolysis (TLG) of primary tumor (PTLG), and TLG of the whole malignant lesion (WTLG) were obtained. Univariate and multivariate analyses were performed to assess the predictive values of metabolic parameters.

Results

Twenty-nine patients showed disease progression and 21 patients died during follow-up. In univariate analysis, positive lymph node, WSUVmax of greater than 11, WMTV of greater than 63 cm3, and WTLG of greater than 373 adversely affected the progression-free survival (P = 0.004, 0.045, 0.023, and 0.005, respectively). A positive lymph node, WSUVmax of greater than 12, WMTV of greater than 68 cm3, and WTLG of greater than 373 significantly adversely affected overall survival (P = 0.002, 0.032, 0.015, and 0.006, respectively). In multivariate analysis, independent prognostic factor for progression-free survival was WTLG (relative risk = 2.384, 95% confidence interval = 1.095–5.187, P = 0.029). Independent prognostic factors for overall survival was WTLG (relative risk = 2.763; 95% confidence interval = 1.107–6.896, P = 0.029).

Conclusions

Preliminary results indicated that pretreatment WTLG measured by F-FDG–PET/CT could independently predict survival in patients with locally advanced SCCC.

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