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Prognostic value of total lesion glycolysis on preoperative 18F-FDG PET/CT in patients with uterine carcinosarcoma

  • Oncology
  • Published:
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Abstract

Objectives

To investigate the relationship between functional tumour parameters measured during preoperative 18F-FDG PET/CT and clinical outcomes in patients with uterine carcinosarcoma.

Methods

For patients with pathologically proven uterine carcinosarcoma, we determined the maximal and average standardized uptake values, cumulative total lesion glycolysis (TLG) and sum of all metabolic tumour volumes (MTVs). Their predictive value for recurrence and the effects of pretreatment functional tumour activity on patient survival were compared.

Results

Clinicopathological data from 28 eligible patients were reviewed. The median duration of progression-free survival was 18.6 months (range 6.1–84.5 months), and 10 (35.7 %) patients experienced recurrences. Univariate analyses showed significant associations between recurrence and tumour size, lymph node metastasis, high TLG and MTV values, and ovarian invasion. Multivariate analysis identified high TLG value as an independent risk factor for recurrence (p = 0.048, hazard ratio 115.261, 95 % confidence interval 1.041–12,765.483). Kaplan–Meier survival curves showed that progression-free survival significantly differed in groups categorized according to TLG (p = 0.007, log-rank test).

Conclusions

Preoperative TLG measured with 18F-FDG PET/CT was statistically significantly associated with uterine carcinosarcoma recurrence. Metabolic parameters can provide useful quantitative criteria for disease prognostication in patients with uterine carcinosarcoma before treatment.

Key Points

• Preoperative TLG was an independent risk factor for recurrence in uterine carcinosarcoma.

• Progression-free survival significantly differed in groups categorized by TLG.

• Metabolic parameters can provide useful quantitative criteria for disease prognostication.

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Abbreviations

CT:

Computed tomography

FIGO:

International Federation of Gynaecology and Obstetrics

18F-FDG:

18F-fluorodeoxyglucose

LN:

Lymph node

MTV:

Metabolic tumour volume

PET:

Positron emission tomography

PFS:

Progression-free survival

SUV:

Standardized uptake value

TLG:

Total lesion glycolysis

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Acknowledgments

The scientific guarantor of this publication is Gi Jeong Cheon. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. This study has received funding by Seoul National University and Seoul National University Hospital. This study was supported by the Research Resettlement Fund for new faculty of Seoul National University, and by grant no. 3420130200 (2013-0362) and grant no. 0320140270 (2014-1040) from the Seoul National University Hospital Research Fund. No complex statistical methods were necessary for this paper. Institutional review board approval was obtained. Written informed consent was waived by the institutional review board.

Methodology: retrospective, diagnostic or prognostic study, multicentre study.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea

    Jeong-Won Lee & Eun Jin Heo

  2. Samsung Advanced Institute for Health Sciences & Technology, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea

    Jeong-Won Lee

  3. Department of Nuclear Medicine, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea

    Seung Hwan Moon

  4. Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea

    Hyunjong Lee & Gi Jeong Cheon

  5. Department of Obstetrics and Gynecology, Cancer Research Institute, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, Republic of Korea

    Maria Lee, Hee Seung Kim & Hyun Hoon Chung

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  1. Jeong-Won Lee
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  2. Eun Jin Heo
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  4. Hyunjong Lee
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Corresponding author

Correspondence to Hyun Hoon Chung.

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Lee, JW., Heo, E.J., Moon, S.H. et al. Prognostic value of total lesion glycolysis on preoperative 18F-FDG PET/CT in patients with uterine carcinosarcoma. Eur Radiol 26, 4148–4154 (2016). https://doi.org/10.1007/s00330-016-4264-z

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  • DOI: https://doi.org/10.1007/s00330-016-4264-z

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