Purpose: Using integrated PET/CT, we evaluated the prognostic value of [F]FDG uptake ratio between pelvic lymph node (LN) and primary tumor in invasive squamous cell carcinoma (SCCA) of the uterine cervix.
Methods: We retrospectively reviewed patients with International Federation of Gynecology and Obstetrics (FIGO) stages IB to IIA cervical SCCA who underwent preoperative [F]FDG PET/CT scans. PET/CT parameters such as maximum standardized uptake value (SUV) of the primary cervical cancer (SUV) and LN (SUV), and the LN-to-cervical cancer SUV ratio (SUV/SUV) were assessed. Prognostic values of PET/CT-derived metabolic and volumetric variables and clinicopathology parameters were analyzed to predict progression-free survival (PFS) in regression analyses.
Results: Clinical data, treatment modalities, and results were reviewed for 103 eligible patients. Median post-surgical follow-up was 29 months (range, 6-89), and 19 (18.5%) patients experienced recurrence. Multivariate logistic regression analysis showed that SUV / SUV > 0.1747(P = 0.048) was the independent risk factor of recurrence. Patient group categorized by SUV/SUV showed significant difference in PFS (log-rank test, P < 0.001).
Conclusions: Preoperative SUV/SUV measured by [F]FDG PET/CT was significantly associated with recurrence, and has an incremental prognostic value for PFS in patients with cervical SCCA.
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