Affiliation:
1. Department of Obstetrics and Gynecology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan
2. Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul
3. Department of Obstetrics and Gynecology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
Abstract
Objective
High-grade neuroendocrine cervical cancer (HGNECC) is a rare and aggressive cervical cancer subtype. In this study, we aimed to evaluate the prognostic value of fluorodeoxyglucose-PET/computed tomography (CT) parameters for HGNECC.
Materials and methods
This single-center retrospective study included 29 patients with HGNECC who underwent fluorodeoxyglucose-PET/CT scan followed by surgery between 2006 and 2016.
Results
The median follow-up period was 40 (range, 4–184) months. After surgery, the resection margins were tumor-negative in 28 patients (96.6%), 8 (27.6%) patients had parametrial tumor invasion, and 7 patients (24.1%) tested positive for lymph node metastasis. The tumor recurred in 20 patients (69%) and 18 patients (62.1%) died during the observation period. In the univariate analyses, age and total lesion glycolysis (TLG) were associated with worse disease-free survival (DFS) (age, hazard ratio 1.056, 95% CI 1.014–1.100, P = 0.009; TLG2.5, hazard ratio 1.003, 95% CI 1–1.006, P = 0.033; and TLG3.0, hazard ratio 1.003, 95% CI 1–1.006, P = 0.034). In the multivariate analyses, older age and higher TLG3.0 were identified as independent poor prognostic factors for DFS (age, hazard ratio 1.058, 95% CI 1.014–1.104, P = 0.009; TLG3.0, hazard ratio 1.004, 95% CI 1–1.007, P = 0.033), while resection margin involvement was identified as an independent factor to predict poor overall survival (hazard ratio 20.717, 95% CI 1.289–332.964, P = 0.032).
Conclusion
Among the preoperative fluorodeoxyglucose-PET/CT parameters, TLG3.0 may be useful for predicting DFS in patients with HGNECC.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Subject
Radiology, Nuclear Medicine and imaging,General Medicine
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