Prediction of Prognosis using Pretreatment FDG PET in Uterine Cervical Carcinoma / 대한핵의학회잡지

ABSTRACT

PURPOSE: In uterine cervical cancer, it is clinically important to predict prognosis on initial staging. We investigated whether abnormally increased FDG uptake of lymph nodes and peak SUV of primary tumor on initial FDG PET can predict prognosis after treatment in cervical cancer patients. MATERIALS AND METHODS: Subjects were 74 newly diagnosed cervical cancer patients (50+/-12yr). Whole body PET was performed after an injection of F-18 FDG. Peak SUV was measured in the primary cervical tumor. Images were interpreted by two nuclear medicine physicians. Follow-up for the disease-free survival was done in all patients. Survival analysis was done by using the Kaplan-Meier method, and a Logrank test was used to compare survival. Cox regression analysis was followed to find independent predictive factors. RESULTS: Recurrence occurred in 13 patients. In univariate analysis, advanced FIGO stage, large size of primary tumor, positive lymph node on MRI or CT, and positive lymph node on PET were significant prognostic factors to predict recurrence. Peak SUV and cell type of tumor failed to show any significant correlation with disease-free survival. In multivariate analysis, positive lymph node on PET (Exp (beta) =6.416, p=0.002) and on CT or MRI (Exp (beta) =5.711, p=0.026) were independent prognostic factors for predicting recurrence. CONCLUSION: In uterine cervical cancer, lymph node metastasis of pretreatment FDG PET is the best independent prognostic factor for predicting recurrence. But, peak SUV was not significant prognostic factor.