Prediction of Recurrence by Preoperative Intratumoral FDG Uptake Heterogeneity in Endometrioid Endometrial Cancer

Seo Young Kang; Gi Jeong Cheon; Maria Lee; Hee Seung Kim; Jae-Weon Kim; Noh-Hyun Park; Yong Sang Song; Hyun Hoon Chung

doi:10.1016/j.tranon.2017.01.002

Prediction of Recurrence by Preoperative Intratumoral FDG Uptake Heterogeneity in Endometrioid Endometrial Cancer

Transl Oncol. 2017 Apr;10(2):178-183. doi: 10.1016/j.tranon.2017.01.002. Epub 2017 Feb 3.

Authors

Seo Young Kang¹, Gi Jeong Cheon¹, Maria Lee², Hee Seung Kim², Jae-Weon Kim², Noh-Hyun Park², Yong Sang Song², Hyun Hoon Chung³

Affiliations

¹ Department of Nuclear Medicine, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea.
² Department of Obstetrics and Gynecology, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea.
³ Department of Obstetrics and Gynecology, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea.. Electronic address: [email protected].

Abstract

Purpose: To investigate the prognostic value of preoperative intratumoral ¹⁸F-FDG uptake heterogeneity (IFH) derived from positron emission tomography (PET)/computed tomography (CT) in patients with endometrioid endometrial cancer.

Methods: We retrospectively evaluated clinicopathological data from patients with pathologically proven endometrioid endometrial cancer who had undergone ¹⁸F-FDG PET/CT scans before surgery. Patients were divided into two groups according to their IFH. The main outcome measure was disease-free survival (DFS).

Results: Between January 2010 and January 2015, data from 72 patients were available for analysis. The median duration of DFS was 23 months (range, 6 to 57 months), and 4 (5.6%) patients experienced recurrence. There were significant differences in tumor size, IFH, and DFS between patients with and without recurrence. In regression analysis, high IFH value [P = .007, hazard ratio (HR) 2.545, 95% confidence interval (CI) 1.468-8.674] was the only independent risk factor for recurrence. The Kaplan-Meier survival graphs showed that DFS significantly differed in groups categorized based on IFH (P < .001, log-rank test).

Conclusions: Preoperative IFH measured by ¹⁸F-FDG PET/CT was associated with recurrence of endometrioid endometrial cancer. The finding supports evidence that FDG-based heterogeneity can be a novel and useful predictor of endometrioid endometrial cancer recurrence.