PET Parameters are Useful in Predicting Endometrial Cancer Risk Classes and Prognosis.

AIM: We investigate the role of preoperative PET parameters to determine risk classes and prognosis of endometrial cancer (EC). METHODS: We enrolled 81 patients with EC who underwent preoperative F-18 FDG PET/CT. PET parameters (SUVmax, SUVmean, MTV, TLG), grade, histology and size of the primary tumor, stage of the disease, the degree of myometrial invasion (MI), and the presence of lymphovascular invasion (LVI), cervical invasion (CI), distant metastasis (DM) and lymph node metastasis (LNM) were recorded. The relationship between PET parameters, clinicopathological risk factors and overall survival (OS) was evaluated. RESULTS: The present study included 81 patients with EC (mean age 60). Of the total sample, 21 patients were considered low risk (endometrioid histology, stage 1A, grade 1 or 2, tumor diameter < 4 cm, and LVI negative) and 60 were deemed high risk. All of the PET parameters were higher in the presence of a high-risk state, greater tumor size, deep MI, LVI and stage 1B-4B. MTV and TLG values were higher in the patients with non-endometrioid histology, CI, grade 3 and LNM. The optimum cut-off levels for differentiating between the high and low risk patients were: 11.1 for SUVmax (AUC = 0.757), 6 for SUVmean (AUC = 0.750), 6.6 for MTV(AUC = 0.838) and 56.2 for TLG(AUC = 0.835). MTV and TLG values were found as independent prognostic factors for OS, whereas SUVmax and SUVmean values were not predictive. CONCLUSIONS: The PET parameters are useful in noninvasively differentiating between risk groups of EC. Furthermore, volumetric PET parameters can be predictive for OS of EC.

The value of uterine artery Doppler and NT-proBNP levels in the second trimester to predict preeclampsia.

OBJECTIVE: To determine the maternal serum N-Terminal proBNP levels in predicting development of preeclampsia. METHOD: Sixty-eight patients were included in the study. The study group consisted of patients with the finding of diastolic notch with abnormal pulsatility index (PI) between 21-24 weeks gestation and the control group consisted of patients without diastolic notch and normal PI. The study included high-risk patients who did not have a history of hypertensive disorder before pregnancy, heart failure, recurrent pregnancy loss, autoimmune disorder or diabetes. The groups were compared in terms of NT-ProBNP levels, development of preeclampsia, obstetric and neonatal problems. RESULTS: There was no significant difference between groups in terms of age, gravidity, parity, uric acid levels, and NT-proBNP levels. There was significant difference between the groups in terms of week of birth, rate of cesarean section and fetal weight. Furthermore, there were significant differences between the two groups when compared in terms of obstetric and neonatal problems (p < 0.05). Obstetric and neonatal problems were more common in the notch with abnormal (PI) group. The NT-pro BNP levels were found to be comparable among groups. Preeclampsia was the most common obstetric problem (11.7%). We were unable to document significant difference in patients who developed preeclampsia. CONCLUSION: Bilateral notch together with abnormal PI measurements in the uterine artery Doppler screening during the second trimester was associated with poor perinatal outcomes. Such an association was not significant in the NT-proBNP measurements. Larger trials focused on late-onset preeclampsia are needed to draw definitive conclusions.

Lack of influence of pregnancy on the prognosis of survivors of thyroid cancer.

OBJECTIVE: The aim of this study is to investigate the influence of pregnancy on prognosis of thyroid cancer. METHODS: A total of 72 patients aged between 15-45 years who underwent total or subtotal thyroidectomy and subsequently radioablation were followed up under suppression. Individuals who had term pregnancies after diagnosis of cancer (group 1, n: 36) and who were non-pregnant (group 2, n:36) were included in the study. Both groups were compared in terms of scintigraphic relapse and metastasis, ultrasonographic relapse, stage change of lympadenopathy at the beginning and at the end of the study. RESULTS: Relapse was detected in 4 out of 36 pregnant patients (11.1%) and in 5 out of 36 non-pregnant patients (13.9%) with no significant difference between groups (p=1.00). Pathologic lymphadenopathy was detected in 2 out of 36 pregnant patients (5.6%) and in 2 out of 36 non-pregnant patients (5.6%) (p=1.00), and metastasis in 3 (8.3%) and in 1 (2.8%), respectively (p=0.61). While stage change was detected in only one pregnant patient (2.8%), and none of the non-pregnant again there was no significant difference (p=1.00). CONCLUSIONS: We conclude that pregnancy does not have an influence on prognosis of thyroid cancer.