The relationship between tumor mean standard uptake value (SUVmax) in preoperative PET/computed tomography and prognostic risk groups in endometrial cancer

Abstract

Objective Our aim in this study was to determine the relationship between tumor mean standard uptake value (SUVmax) value in preoperative PET/computed tomography (CT) and prognostic risk groups in cases with endometrial cancer. Methods A total of 368 patients operated on for endometrial cancer were evaluated in the study. The SUVmax value of endometrial primary tumor of the patients screened within 30 days of operation, was compared with prognostic parameters and risk groups. P value <0.05 was considered significant for all tests. Results A statistically significant relationship was found between the mean SUVmax value and risk groups (P < 0.001), grade (P < 0.001), stage (P < 0.001), myometrial invasion of the tumor (P < 0.001), cervical involvement (P = 0.002), lymphovascular space invasion (LVSI) (P < 0.001), lymph node metastasis (P < 0.001), tumor size (P < 0.001), lymph node involvement in PET/CT (P < 0.001). There was no significant relationship found between the histologic type of tumor and the mean SUVmax value (P = 0.113). Cutoff SUVmax value for endometrial cancer tumor tissue, which will be used to determine the possible lymph node metastasis, was accepted as 19 as a result of the ROC analysis. The risk of lymph node metastasis was found 4.74 times (confidence interval, 2.510–8.977) higher in patients with SUVmax value above cutoff 19 (P < 0.001). Considering risk groups, it was observed that patients with mean SUVmax value above 19 were in intermediate-high and high risk group, 2.3 times more than those in low and intermediate risk group (P < 0.001). As a result of logistic regression analysis, in determining intermediate-high and high-risk groups, histological type (P < 0.001), myometrial invasion (P = 0.003), cervical invasion (CI) (P < 0.001), grade (P = 0.018) and SUVmax value (P = 0.028) had statistically significant importance. Conclusion The higher the mean SUVmax value in the endometrial cancer tumor tissue in preoperative PET/CT in patients with endometrial cancer, the higher the risk group of the patients.