Abstract
To assess the prognostic relevance of volume-based parameters [whole body (wb)-metabolic tumor volume (MTV) and wb-total lesion glycolysis (TLG)] of pretreatment PET/CT in patients with potentially platinum-responsive recurrent ovarian cancer. This retrospective investigation analyzed 67 patients at first relapse. At univariate analysis, post-relapse survival and overall survival correlated with residual disease after primary surgery (RD) (p=0.015 and 0.049, respectively), time to recurrence (p=0.005 and p=0.0003), number of recurrence sites (p=0.001 and p=0.0005), treatment at recurrence (p=0.044 and 0.043) and wb-MTV (p=0.023 and 0.021) but not with wb-TLG. RD, time to recurrence and number of recurrence sites, but not wb-MTV, were independent prognostic variables for post-relapse survival, and time to recurrence and number of recurrence sites, but not wb-MTV, were independent prognostic factors for overall survival. Volume-based parameters of PET/CT are not independent predictors of clinical outcome in potentially platinum-responsive recurrent ovarian cancer.
Highlights
Epithelial ovarian cancer is the gynecological malignancy with the worst prognosis because of the frequent advanced stage at presentation and the elevated biological aggressiveness
Chemotherapy is the standard of care of these patients, whereas secondary cytoreductive surgery should be reserved for accurately selected cases [2,3,4,5,6,7,8]
Whole body-metabolic tumor volume (MTV) and wbtotal lesion glycolysis (TLG) are volume-based parameters developed to measure the metabolic activity in the entire tumor [23, 24]
Summary
Epithelial ovarian cancer is the gynecological malignancy with the worst prognosis because of the frequent advanced stage at presentation and the elevated biological aggressiveness. The term platinum-sensitive should be changed into potentially-platinum responsive, corresponding to a patient who responded to prior platinum without early symptomatic relapse. 2-deoxy-2-[18F]-fluorodeoxyglucose (FDG)-positron emission tomography (PET)/computed tomography (CT) is very useful for detecting recurrent ovarian cancer and for identifying the patients who are more likely to benefit from secondary cytoreductive surgery [10,11,12,13,14,15,16,17,18,19,20,21]. In the present retrospective investigation, we assessed the prognostic relevance of SUVmax, wb-MTV and wb-TLG in 18F-FDG-PET/CT performed in patients with potentially platinum-responsive recurrent ovarian cancer
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