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  • [Eur J Nucl Med Mol Imaging.] Prognostic importance of lymph node-to-primary tumor standardized uptake value ratio in invasive squamous cell carcinoma of uterine cervix.

    [Eur J Nucl Med Mol Imaging.] Prognostic importance of lymph node-to-primary tumor standardized uptake value ratio in invasive squamous cell carcinoma of uterine cervix.

    서울의대 / 정현훈*

  • 출처
    Eur J Nucl Med Mol Imaging.
  • 등재일
    2017 Oct
  • 저널이슈번호
    44(11):1862-1869.
  • 내용

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    Abstract

    PURPOSE:

    Using integrated PET/CT, we evaluated the prognostic value of [18F]FDG uptake ratio between pelvic lymph node (LN) and primary tumor in invasive squamous cell carcinoma (SCCA) of the uterine cervix.

     

    METHODS:

    We retrospectively reviewed patients with International Federation of Gynecology and Obstetrics (FIGO) stages IB to IIA cervical SCCA who underwent preoperative [18F]FDG PET/CT scans. PET/CT parameters such as maximum standardized uptake value (SUV) of the primary cervical cancer (SUVcervix) and LN (SUVLN), and the LN-to-cervical cancer SUV ratio (SUVLN/SUVcervix) were assessed. Prognostic values of PET/CT-derived metabolic and volumetric variables and clinicopathology parameters were analyzed to predict progression-free survival (PFS) in regression analyses.


    RESULTS:

    Clinical data, treatment modalities, and results were reviewed for 103 eligible patients. Median post-surgical follow-up was 29 months (range, 6-89), and 19 (18.5%) patients experienced recurrence. Multivariate logistic regression analysis showed that SUVLN / SUVcervix > 0.1747(P = 0.048) was the independent risk factor of recurrence. Patient group categorized by SUVLN/SUVcervix showed significant difference in PFS (log-rank test, P < 0.001).


    CONCLUSIONS:

    Preoperative SUVLN/SUVcervix measured by [18F]FDG PET/CT was significantly associated with recurrence, and has an incremental prognostic value for PFS in patients with cervical SCCA.

     

    Author information

    Chung HH1, Cheon GJ2, Kim JW3, Park NH3, Song YS3.

    Department of Obstetrics and Gynecology, Cancer Research Institute, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea. chhkmj@gmail.com.

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

    Department of Obstetrics and Gynecology, Cancer Research Institute, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea. 

  • 키워드
    Cervical cancer; Ln; Ratio; SCCA; [18F]FDG pet/Ct​
  • 연구소개
    FIGO stage IB- IIA의 자궁경부 편평상피암으로 수술 전 [18F]FDG PET/CT를 시행한 환자들에서 골반 림프절의 SUV를 자궁경부암 SUV에 비교하여, 이 비율이 가지는 임상적 의미를 파악하고자 한 연구입니다. 전이가 의심되는 부위의 SUV 절대값 보다는 원발암과 비교한 FDG uptake 정도가 종양의 공격성을 보다 잘 반영할 것이라는 가설을 확인하기 위한 것이었습니다. 분석결과, 자궁경부암에 대한 골반 림프절 FDG uptake 비율이 재발의 독립적 예후인자임을 확인하였고, 이에 임상적으로 유용한 새로운 예후예측 인자로써의 가능성을 제시한 연구입니다.
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