Tumor total lesion glycolysis and number of positive pelvic lymph nodes on pretreatment positron emission tomography/computed tomography (PET/CT) predict survival in patients with locally advanced cervical cancer.
DE CUYPERE, Marjolein; Lovinfosse, Pierre; Gennigens, Christineet al.
2020 • In International Journal of Gynecological Cancer, 0, p. 1-8
[en] OBJECTIVE: The aim of this study was to investigate the prognostic value of metabolic parameters obtained at pretreatment [(18)F]fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography ([(18)F]FDG PET/CT) in patients with locally advanced cervical cancer. We hypothesize that these metabolic parameters could optimize the treatment decision and thus favor the outcome of patients suffering locally advanced cervical cancer. METHODS: Patients with locally advanced cervical cancer underwent pretreatment PET/CT. Standard uptake values (maximum, mean, peak), metabolic tumor volume, and total lesion glycolysis were measured in the tumor and in the hypermetabolic pelvic lymph nodes. The relationship between clinical, pathological, and PET/CT metabolic parameters with recurrence-free survival and overall survival was assessed by Cox regression analysis. RESULTS: 115 patients with a median age of 52 years (range 23-77) presented with locally advanced cervical cancer. After a mean follow-up of 33.0 months after initiation of therapy, 26 patients (22.6%) recurred of which 17 patients had distant metastasis; 18 (15.7%) patients died. Recurrence-free survival at 2 and 5 years was 79.2% and 72.2%, respectively. The total lesion glycolysis of the tumor and the delay between diagnosis and treatment were significantly associated with recurrence-free survival in the multivariate analysis (HR 1.00, p=0.004, and HR 2.04, p=0.02, respectively). Only the total lesion glycolysis of the tumor ≥373.54 (HR 2.49, 95% CI 1.15 to 5.38; p=0.02) remained significant after log rank testing. Overall survival at 2 and 5 years was 91.7% and 68.8%, respectively. The number of PET-positive pelvic lymph nodes was the only independent prognostic factor for overall survival in the multivariate analysis (HR 1.43, 95% CI 1.13 to 1.81; p=0.003). CONCLUSION: Tumor total lesion glycolysis and the number of positive pelvic lymph nodes on pretreatment PET/CT appear to be independent prognostic factors for recurrence and survival in patients with locally advanced cervical cancer. This may help to select patients who may benefit from therapeutic optimization and closer surveillance.
Disciplines :
Oncology
Author, co-author :
DE CUYPERE, Marjolein ✱; Centre Hospitalier Universitaire de Liège - CHU > Département de gynécologie-obstétrique > Secteur oncologie
Lovinfosse, Pierre ✱; Centre Hospitalier Universitaire de Liège - CHU > Département de Physique Médicale > Service médical de médecine nucléaire et imagerie onco
Gennigens, Christine ; Université de Liège - ULiège > Département des sciences cliniques > Département des sciences cliniques
HERMESSE, Johanne ; Centre Hospitalier Universitaire de Liège - CHU > Département de Physique Médicale > Service médical de radiothérapie
Rovira, Ramon
Duch, Joan
GOFFIN, Frédéric ; Centre Hospitalier Universitaire de Liège - CHU > Département de gynécologie-obstétrique > Secteur gynécologie
Hustinx, Roland ; Université de Liège - ULiège > Département des sciences cliniques > Médecine nucléaire
Kridelka, Frédéric ; Université de Liège - ULiège > Département des sciences cliniques > Gynécologie-Obstétrique
✱ These authors have contributed equally to this work.
Language :
English
Title :
Tumor total lesion glycolysis and number of positive pelvic lymph nodes on pretreatment positron emission tomography/computed tomography (PET/CT) predict survival in patients with locally advanced cervical cancer.
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