The relationship between posttreatment 18F-fluorodeoxyglucose PET/computed tomography restaging and metabolic parameters with the prognosis of uterine cervical cancer

Abstract

Objective To evaluate the relationship between posttreatment 18 F-fluorodeoxyglucose ( 18 F-FDG) PET/computed tomography (CT) restaging with metabolic parameters and prognosis of uterine cervical cancer. Methods A total of 151 patients with cervical cancer who underwent 18 F-FDG PET/CT examination were retrospectively analyzed. The correlation between PET/CT restaging, maximum standard uptake value, whole body metabolic tumor volume (wbMTV), whole body total lesion glycolysis (wbTLG), related clinical factors, and prognosis was analyzed. Kaplan–Meier survival analysis was used to perform univariate analysis on clinical parameters and imaging parameters, and Cox’s proportional hazards regression model was used to perform multifactor analysis to explore the related factors affecting progression-free survival (PFS) and overall survival (OS) of patients with cervical cancer. Results With a median follow-up time of 24 months, the median OS of 151 cervical cancer patients was 43 months, and the 5-year survival rate was 50%; the median PFS was 33 months, and the 5-year PFS rate was 29%. Both univariate and multivariate analyses showed that PET/CT restaging and squamous cell carcinoma antigen (SCC-Ag) were significant prognostic factors for OS and PFS. Moreover, patients with downstaged PET/CT restaging showed significantly better 5-year OS and 5-year PFS rates than those no downstaging (87.0 vs. 24.6%; P < 0.001 for OS; 50.7 vs. 18.5%; P < 0.001 for PFS). Among patients with positive PET/CT findings, wbTLG and wbMTV were identified as independent prognostic factors for OS and PFS, respectively. Conclusion 18 F-FDG PET/CT restaging, serum SCC-Ag, wbMTV, and wbTLG are established as prognostic biomarkers in recurrent cervical cancer. Posttreatment PET/CT represents a sensitive and accurate imaging technique for predicting patient outcomes.

Affiliated Institutions

• National Clinical Research US
• Chinese PLA General Hospital CN
• Tianjin Medical University Cancer Institute and Hospital CN

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