Prognostic value of pretreatment FDG PET/CT in uterine cervical cancer according to two major histologic types: squamous cell carcinoma and adenocarcinoma

Objective(s): The aim of this study was to assess the prognostic value of pretreatment Positron emission tomography / computed tomography using ۱۸F-fluorodeoxyglucose (FDG-PET/CT) in cervical cancer according to two major histologic types.Methods: Eighty-three squamous cell carcinoma (SCC) patients and ۳۵ adenocarcinoma (AC) patients who underwent pretreatment FDG-PET/CT were retrospectively analyzed. Maximum standardized uptake value (SUVmax), mean standardized uptake value (SUVmean), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) of the primary tumor were calculated. Kaplan-Meier analyses were used to compare correlations between each PET parameter and overall survival (OS). The prognostic values of imaging and clinical parameters were assessed using uni- and multivariable Cox proportional hazard models.Results: SUVmax, SUVmean, and TLG were significantly higher in SCC than in AC (p<۰.۰۱ each). No significant difference in MTV was seen between the two groups (p=۰.۱۰). As for Kaplan-Meier analyses, in SCC, patients with SUVmax, SUVmean, MTV, and TLG exceeding cutoff values tended to show worse OS than patients with lower values (p=۰.۰۷, p=۰.۲۷, p<۰.۰۱, and p=۰.۰۱, respectively, for OS). On the other hand, in AC, patients with MTV and TLG exceeding cutoff values showed significantly worse PFS and OS (p<۰.۰۱ each for OS), while SUVmax and SUVmean were unrelated to OS (p=۰.۹۱ and p=۰.۸۳, respectively for OS). As for multivariable analyses, in SCC, TLG was identified as an independent prognostic factor for OS (p=۰.۰۱). In AC, MTV was identified as an independent prognostic factor for OS (p=۰.۰۲).Conclusion: Our preliminary data suggest that FDG-PET/CT would be useful for predicting prognosis in cervical cancer, although the clinical significance of quantitative values may differ according to histopathological type.

Keywords:

cervical uterine cancer , uterine cervical adenocarcinoma , Prognostic Value , FDG