Prognostic Impact of Pretreatment Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography SUVmax in Patients With Locally Advanced Cervical Cancer

Objective The aim of this study was to investigate the impact of SUV max fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) measured in the primary tumor, pelvic and para-aortic node with disease-free survival (DFS) and overall survival (OS) in patients with locally advanced cervical cancer. Methods and Materials A total of 92 patients with histological diagnosis of locally advanced cervical cancer are treated with radiochemotherapy plus brachytherapy boost from January 2008 to April 2014 in our Institution. A pretreatment FDG-PET/CT for staging and radiotherapy planning was performed, and the value of SUV max measured in primary tumor and positive nodes was related to DFS and OS. Results Univariate analysis showed that DFS is related to FDG-PET/CT positive para-aortic nodes ( P = 0.01), International Federation of Gynecology and Obstetrics (FIGO) stage of disease ( P = 0.01), and primary tumor SUV max ( P = 0.02), and OS is related to positive para-aortic nodes ( P = 0.01) and primary tumor SUV max ( P = 0.02). In multivariate analysis, DFS is modified by FDG-PET/CT positive para-aortic lymph nodes, stage and high T SUV max ( P = 0.02; P = 0.003; P = 0.04), but the only worse prognostic factor of OS is the high SUV max in the primary tumor ( P = 0.01). Conclusions We found that T SUV max , stage, and para-aortic lymph node status assessed by FDG-PET were independent prognostic factors of DFS, whereas only T SUV max correlated with OS.