Purpose: The aim of this retrospective multicentric study was to investigate the diagnostic performance, the prognostic value and the impact of F-FDG PET/CT on treatment decision-making in patients with suspected recurrent vulvar cancer (VC).
Materials And Methods: Sixty-three patients affected by VC performed F-FDG-PET/CT for restaging purposes in case of suspected clinical and/or radiological recurrence. Histopatology results if available and/or clinical-imaging follow-up for at least 12 months were considered as reference standard. The diagnostic accuracy and the clinical impact of F-FDG PET/CT were investigated. Progression free survival (PFS) and overall survival (OS) were calculated using Kaplan-Meier curves.
Results: Fifty-two (82.5%) PET/CT showed the presence of recurrence, while the remaining 11 (17.5%) were negative. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of PET/CT were 100% (95%CI 93-100%), 92% (95%CI 62-100%), 98% (95%CI 89-99%), 100% and 98% (95%CI 92-100%). A relevant impact of F-FDG PET/CT imaging was registered in 28 cases: in 12 cases moving from local therapy to chemotherapy due to the recognition of disseminate localizations; in 10 showing the site of recurrence in presence of negative conventional imaging, and in 6 cases confirming to be true negative and avoiding unnecessary therapies. Beside advanced age and HPV status, a positive restaging F-FDG PET/CT scan was significantly correlated with shorter PFS and OS compared to negative scan (p < 0.001).
Conclusions: F-FDG PET/CT demonstrated to be an accurate tool in the assessing of recurrent VC with high sensitivity and specificity and with a significant impact on clinical decision-making. Restaging F-FDG PET/CT findings were associated with survival.
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| http://dx.doi.org/10.1007/s11604-021-01173-x | DOI Listing |
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