Prognostic value of total lesion glycolysis measured by 18F-FDG PET/CT in patients with locally advanced cervical cancer

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Abstract

Aim The aim of this study was to determine the most relevant parameters of fluorine-18 fluorodeoxyglucose (18 F-FDG) PET/computed tomography (CT) for predicting recurrence in patients with locally advanced cervical cancer. Materials and methods Fifty-six patients diagnosed with International Federation of Gynecology and Obstetrics (FIGO) stage IIB to IVA cervical cancer who underwent 18 F-FDG PET/CT before definitive chemoradiotherapy were retrospectively enrolled. Various PET parameters, namely, maximum standardized uptake value, mean standardized uptake value, metabolic tumor volume, and total lesion glycolysis (TLG) of the primary tumor, were analyzed to evaluate the relationship between these PET parameters and recurrence-free survival (RFS). The cut-off values of PET parameters that showed the best trade-off between sensitivity and specificity for RFS were determined by receiver operating characteristic curve analysis. Results The median follow-up was 20 months (range, 6-63 months). Univariate analysis indicated that higher FIGO stage [hazard ratio (HR) 5.606, 95% confidence interval (CI) 1.682-18.68, P=0.005], metabolic tumor volume more than 47.81 cm3 (HR 6.203, 95% CI 1.351-28.481, P=0.019), and TLG more than 215.02 (HR 11.817, 95% CI 1.518-91.963, P=0.018) were associated with RFS. In multivariate analysis, FIGO stage (HR 4.618, 95% CI 1.295-16.463, P=0.018) and TLG more than 215.02 (HR 10.171, 95% CI 1.246-83.044, P=0.030) were independent predictive factors for RFS. Kaplan-Meier curves for RFS indicated that patients with TLG less than or equal to 215.02 showed better RFS (P=0.003). Conclusion Pretreatment TLG proved to be an independent prognostic factor for RFS in patients with locally advanced cervical cancer treated by definitive chemoradiotherapy.

Original languageEnglish
Pages (from-to)843-848
Number of pages6
JournalNuclear Medicine Communications
Volume37
Issue number8
DOIs
Publication statusPublished - 2016 Aug 1

Fingerprint

Fluorodeoxyglucose F18
Glycolysis
Uterine Cervical Neoplasms
Tomography
Recurrence
Survival
Confidence Intervals
Gynecology
Obstetrics
Chemoradiotherapy
Tumor Burden
ROC Curve
Multivariate Analysis
Sensitivity and Specificity

Keywords

  • F-FDG PET/CT
  • cervical cancer
  • recurrence
  • survival
  • total lesion glycolysis

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

@article{0e67a090e0004aae910ded421c5396d2,
title = "Prognostic value of total lesion glycolysis measured by 18F-FDG PET/CT in patients with locally advanced cervical cancer",
abstract = "Aim The aim of this study was to determine the most relevant parameters of fluorine-18 fluorodeoxyglucose (18 F-FDG) PET/computed tomography (CT) for predicting recurrence in patients with locally advanced cervical cancer. Materials and methods Fifty-six patients diagnosed with International Federation of Gynecology and Obstetrics (FIGO) stage IIB to IVA cervical cancer who underwent 18 F-FDG PET/CT before definitive chemoradiotherapy were retrospectively enrolled. Various PET parameters, namely, maximum standardized uptake value, mean standardized uptake value, metabolic tumor volume, and total lesion glycolysis (TLG) of the primary tumor, were analyzed to evaluate the relationship between these PET parameters and recurrence-free survival (RFS). The cut-off values of PET parameters that showed the best trade-off between sensitivity and specificity for RFS were determined by receiver operating characteristic curve analysis. Results The median follow-up was 20 months (range, 6-63 months). Univariate analysis indicated that higher FIGO stage [hazard ratio (HR) 5.606, 95{\%} confidence interval (CI) 1.682-18.68, P=0.005], metabolic tumor volume more than 47.81 cm3 (HR 6.203, 95{\%} CI 1.351-28.481, P=0.019), and TLG more than 215.02 (HR 11.817, 95{\%} CI 1.518-91.963, P=0.018) were associated with RFS. In multivariate analysis, FIGO stage (HR 4.618, 95{\%} CI 1.295-16.463, P=0.018) and TLG more than 215.02 (HR 10.171, 95{\%} CI 1.246-83.044, P=0.030) were independent predictive factors for RFS. Kaplan-Meier curves for RFS indicated that patients with TLG less than or equal to 215.02 showed better RFS (P=0.003). Conclusion Pretreatment TLG proved to be an independent prognostic factor for RFS in patients with locally advanced cervical cancer treated by definitive chemoradiotherapy.",
keywords = "F-FDG PET/CT, cervical cancer, recurrence, survival, total lesion glycolysis",
author = "Jin-Hwa Hong and Jung, {Un Suk} and Min, {Kyung Jin} and Lee, {Jae Kwan} and Sungeun Kim and Eo, {Jae Seon}",
year = "2016",
month = "8",
day = "1",
doi = "10.1097/MNM.0000000000000516",
language = "English",
volume = "37",
pages = "843--848",
journal = "Nuclear Medicine Communications",
issn = "0143-3636",
publisher = "Lippincott Williams and Wilkins",
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TY - JOUR

T1 - Prognostic value of total lesion glycolysis measured by 18F-FDG PET/CT in patients with locally advanced cervical cancer

AU - Hong, Jin-Hwa

AU - Jung, Un Suk

AU - Min, Kyung Jin

AU - Lee, Jae Kwan

AU - Kim, Sungeun

AU - Eo, Jae Seon

PY - 2016/8/1

Y1 - 2016/8/1

N2 - Aim The aim of this study was to determine the most relevant parameters of fluorine-18 fluorodeoxyglucose (18 F-FDG) PET/computed tomography (CT) for predicting recurrence in patients with locally advanced cervical cancer. Materials and methods Fifty-six patients diagnosed with International Federation of Gynecology and Obstetrics (FIGO) stage IIB to IVA cervical cancer who underwent 18 F-FDG PET/CT before definitive chemoradiotherapy were retrospectively enrolled. Various PET parameters, namely, maximum standardized uptake value, mean standardized uptake value, metabolic tumor volume, and total lesion glycolysis (TLG) of the primary tumor, were analyzed to evaluate the relationship between these PET parameters and recurrence-free survival (RFS). The cut-off values of PET parameters that showed the best trade-off between sensitivity and specificity for RFS were determined by receiver operating characteristic curve analysis. Results The median follow-up was 20 months (range, 6-63 months). Univariate analysis indicated that higher FIGO stage [hazard ratio (HR) 5.606, 95% confidence interval (CI) 1.682-18.68, P=0.005], metabolic tumor volume more than 47.81 cm3 (HR 6.203, 95% CI 1.351-28.481, P=0.019), and TLG more than 215.02 (HR 11.817, 95% CI 1.518-91.963, P=0.018) were associated with RFS. In multivariate analysis, FIGO stage (HR 4.618, 95% CI 1.295-16.463, P=0.018) and TLG more than 215.02 (HR 10.171, 95% CI 1.246-83.044, P=0.030) were independent predictive factors for RFS. Kaplan-Meier curves for RFS indicated that patients with TLG less than or equal to 215.02 showed better RFS (P=0.003). Conclusion Pretreatment TLG proved to be an independent prognostic factor for RFS in patients with locally advanced cervical cancer treated by definitive chemoradiotherapy.

AB - Aim The aim of this study was to determine the most relevant parameters of fluorine-18 fluorodeoxyglucose (18 F-FDG) PET/computed tomography (CT) for predicting recurrence in patients with locally advanced cervical cancer. Materials and methods Fifty-six patients diagnosed with International Federation of Gynecology and Obstetrics (FIGO) stage IIB to IVA cervical cancer who underwent 18 F-FDG PET/CT before definitive chemoradiotherapy were retrospectively enrolled. Various PET parameters, namely, maximum standardized uptake value, mean standardized uptake value, metabolic tumor volume, and total lesion glycolysis (TLG) of the primary tumor, were analyzed to evaluate the relationship between these PET parameters and recurrence-free survival (RFS). The cut-off values of PET parameters that showed the best trade-off between sensitivity and specificity for RFS were determined by receiver operating characteristic curve analysis. Results The median follow-up was 20 months (range, 6-63 months). Univariate analysis indicated that higher FIGO stage [hazard ratio (HR) 5.606, 95% confidence interval (CI) 1.682-18.68, P=0.005], metabolic tumor volume more than 47.81 cm3 (HR 6.203, 95% CI 1.351-28.481, P=0.019), and TLG more than 215.02 (HR 11.817, 95% CI 1.518-91.963, P=0.018) were associated with RFS. In multivariate analysis, FIGO stage (HR 4.618, 95% CI 1.295-16.463, P=0.018) and TLG more than 215.02 (HR 10.171, 95% CI 1.246-83.044, P=0.030) were independent predictive factors for RFS. Kaplan-Meier curves for RFS indicated that patients with TLG less than or equal to 215.02 showed better RFS (P=0.003). Conclusion Pretreatment TLG proved to be an independent prognostic factor for RFS in patients with locally advanced cervical cancer treated by definitive chemoradiotherapy.

KW - F-FDG PET/CT

KW - cervical cancer

KW - recurrence

KW - survival

KW - total lesion glycolysis

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