EP062/#902 The standarized uptake value for F-18 flurodeoxyglucose positron emission tomography as a predictive marker for cervical cancer recurrence and progression free survival

Objectives

Patients with locally advanced cervical cancer (CC) have pre-treatment imaging before definitive chemoradiation. We aimed to evaluate the prognostic value of the maximal standardized uptake value (SUV(max)) of F-18 fluorodeoxyglucose (FDG) on positron emission tomography (PET), in patients with locally advanced CC treated by chemoradiation.

Methods

We performed a retrospective study of 50 consecutive CC patients who underwent pretreatment FDG-PET, and were treated by chemoradiation. All medical records, imaging studies, and laboratory tests were reviewed. PET images were re-evaluated by blinded nuclear medicine radiologists. The analysis included measurement of SUVmax, tumor size, and lymph node involvement. Univariable analysis was performed using Mann-Whitney test. Kaplan-Meier curves were used for survival analyses.

Results

Median tumor size was 4.8 cm [range 3.4–6.0]. Lymph node involvement was found in 35 (70.0%) of women. 20 patients (40.0%) had stage 2B disease. Median SUVmax was 16.5 [range 4.6–30.0]. There were 14 (28.0%) recurrences, with a median PFS of 13 months. The mean SUVmax was similar between stages of disease, involvement of adjacent organs and parametrium, lymph node involvement and tumor size. Mean SUVmax did not differ between cases of recurrence and no recurrence (p=0.239), but was higher in women who died of disease (17.7±4.8 vs. 14.6±4.8, p=0.037). A cut-off value of SUVmax=12.7 was found to predict recurrence (95% CI 0.453–0.763) but not Overall survival.

Conclusions

The SUVmax cutoff value of 12.7, was correlated with an increased risk for recurrence and decrease in PFS in CC patients treated by chemoradiation, but did not correlate with overall survival.