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Prognostic significance of mediastinal 18F-FDG uptake in PET/CT in advanced ovarian cancer

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

To evaluate the prognostic significance of increased mediastinal 18F-FDG uptake in PET/CT for the staging of advanced ovarian cancer.

Methods

We retrospectively evaluated patients managed for FIGO stage III/IV ovarian cancer between 1 January 2006 and 1 June 2009. Patients were included if they had undergone 18F-FDG PET/CT and surgery for initial staging. Exclusion criteria were age younger than 18 years, inability to undergo general anaesthesia, recurrent ovarian cancer, and borderline or nonepithelial malignancy. Whole-body PET/CT was performed after intravenous 18F-FDG injection. The location of abnormal hot spots and 18F-FDG maximal standard uptake values (SUVmax) were recorded. We compared the complete cytoreduction and survival rates in groups defined based on mediastinal 18F-FDG uptake and SUVmax values. Kaplan-Meier curves of overall survival and disease-free survival were compared using the log-rank test. Hazard ratios with their 95% confidence intervals were computed. Adjusted hazard ratios were obtained using a multivariate Cox model.

Results

We included 53 patients, of whom 17 (32%) had increased mediastinal 18F-FDG uptake. Complete cytoreduction was achieved in 14 (87.5%) of the 16 patients managed with primary surgery and in 21 (75%) of the 28 patients managed with interval surgery. Complete cytoreduction was achieved significantly more often among patients without increased mediastinal 18F-FDG uptake (80.6% vs. 35.3%; p = 0.001). Disease-free survival was comparable between the two groups. By univariate analysis, overall mortality was significantly higher among patients with increased mediastinal 18F-FDG uptake (hazard ratio 5.70, 95% confidence interval 1.74–18.6). The only factor significantly associated with overall survival by multivariate analysis was complete cytoreduction (adjusted hazard ratio 0.24, 95% confidence interval 0.07–0.89).

Conclusion

Increased mediastinal 18F-FDG uptake was common in patients with advanced ovarian cancer. However, complete cytoreduction, which was significantly more frequent among patients without mediastinal 18F-FDG uptake, was the only factor independently associated with survival.

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Authors and Affiliations

  1. Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, Paris, France

    Anne-Sophie Bats, Florent Hugonnet, Cyrille Huchon, Marc Faraggi & Fabrice Lécuru

  2. Assistance Publique-Hôpitaux de Paris, Service de Chirurgie Gynécologique et Cancérologique, Hôpital Européen Georges-Pompidou, Paris, France

    Anne-Sophie Bats, Cyrille Huchon, Chérazade Bensaid & Fabrice Lécuru

  3. Assistance Publique-Hôpitaux de Paris, Service de Médecine Nucléaire, Hôpital Européen Georges-Pompidou, Paris, France

    Florent Hugonnet, Nadia Pierquet-Ghazzar & Marc Faraggi

  4. INSERM UMR-S 747, Université Paris Descartes, Sorbonne Paris Cité, Paris, France

    Anne-Sophie Bats & Fabrice Lécuru

Authors
  1. Anne-Sophie Bats
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  2. Florent Hugonnet
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  3. Cyrille Huchon
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  4. Chérazade Bensaid
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  5. Nadia Pierquet-Ghazzar
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  6. Marc Faraggi
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  7. Fabrice Lécuru
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Correspondence to Anne-Sophie Bats.

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Bats, AS., Hugonnet, F., Huchon, C. et al. Prognostic significance of mediastinal 18F-FDG uptake in PET/CT in advanced ovarian cancer. Eur J Nucl Med Mol Imaging 39, 474–480 (2012). https://doi.org/10.1007/s00259-011-1984-9

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  • DOI: https://doi.org/10.1007/s00259-011-1984-9

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