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Metabolic tumour volume and total lesion glycolysis, measured using preoperative 18 F– FDG PET / CT , predict the recurrence of endometrial cancer
Author(s) -
Shim SH,
Kim DY,
Lee DY,
Lee SW,
Park JY,
Lee JJ,
Kim JH,
Kim YM,
Kim YT,
Nam JH
Publication year - 2014
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/1471-0528.12543
Subject(s) - medicine , endometrial cancer , hazard ratio , receiver operating characteristic , standardized uptake value , proportional hazards model , stage (stratigraphy) , breast cancer , confidence interval , retrospective cohort study , univariate analysis , nuclear medicine , cancer , positron emission tomography , radiology , multivariate analysis , paleontology , biology
Objective To investigate the prognostic value of metabolic tumour volume ( MTV ) and total lesion glycolysis ( TLG ), measured by preoperative positron emission tomography and computerised tomography ( PET / CT ), in women with endometrial cancer. Design Retrospective cohort study. Setting A tertiary referral centre. Population Women with endometrial cancer who underwent preoperative 18 F‐ FDG PET / CT in the period 2004–2009. Methods Clinicopathological data for 84 women with endometrial cancer were reviewed from medical records. Cox proportional hazards modelling identified recurrence predictors. The receiver operating characteristic ( ROC ) curve was used to determine the cut‐off value for predicting recurrence. Main outcome measure Disease‐free survival ( DFS ). Results The number of patients with International Federation of Gynecology and Obstetrics (FIGO) stages were: I (58); II (11); III (13); and IV (2). The median DFS was 48 (1–85) months. By univariate analysis, DFS was significantly associated with FIGO stage, histology, peritoneal cytology, myometrial invasion, nodal metastasis, serum CA‐125, MTV, and TLG. Using multivariate analysis, the MTV ( P = 0.010; hazard ratio, HR = 1.010; 95% confidence interval, 95% CI = 1.002–1.018) and TLG ( P = 0.024; HR = 1.001; 95% CI = 1.000–1.002) were associated with DFS. The area under the ROC curve was 0.679 (95% CI = 0.505–0.836) after discriminating for recurrence using an MTV cut‐off value of 17.15 ml. Regarding TLG, the cut‐off value was 56.43 g and the area under the ROC plot was 0.661 (95% CI = 0.501–0.827). Kaplan–Meier survival graphs demonstrated a significant difference in DFS between groups categorised using the cut‐off values for MTV and TLG ( P < 0.022 for MTV and P < 0.047 for TLG, by log‐rank test). Conclusions Preoperative MTV and TLG could be independent prognostic factors predicting the recurrence of endometrial cancer.