Abstract 1498
Background
The role of F-18 FDG PET/CT to predict primary optimal cytoreductive surgery for advanced ovarian cancer has not been reported. The aim of this study was to evaluate the predictive value of SUVmax on FDG PET/CT to predict suboptimal cytoreduction and to make risk model for predicting suboptimal cytoreduction using metabolic parameters in advanced ovarian cancer.
Methods
From 2011-2015, 51 patient underwent primary cytoreductive surgery for advanced ovarian cancer (FIGO stage III-IV). Residual disease measuring > 1 cm in maximal diameter was considered a suboptimal surgical result. Whole body 1 SUVmax (WB1SUVmax) was defined as sum of SUVmax in nine abdominal regions (central, right upper, epigastrium, left upper, left flank, left lower, pelvis, right lower, right flank). Whole body 2 SUVmax (WB2SUVmax) was added SUVmax of 3 regional lymph nodes (pelvis, paraaortic and extra-abdominal) to WB1SUVmax. We used the multiple logistic regression analysis to determine predictive value of WBSUVmax. Furthermore, disease-free survival (DFS) and overall survival (OS) were performed using risk model.
Results
Seventeen of 51 patients (33.3%) underwent suboptimal cytoreduction. According to the univariate analysis only ECOG status was associated with suboptimal cytoreduction with marginal significance among the clinical parameters (OR, 4.091; 95% CI, 0.97-17.29; p = 0.0520). Among the PET metabolic parameters, PET central (OR, 5.250; 95% CI, 1.41-19.59; p = 0.0136), PET right upper (OR, 4.148; 95% CI, 1.13-15.19; p = 0.0317), and PET left upper (OR, 5.921; 95% CI, 1.17-30.02; p = 0.0318) were significantly associated with prediction of suboptimal cytoreduction. Moreover, WB2SUVmax was significantly associated with suboptimal cytoreduction (OR, 4.148; 95% CI, 1.13-15.19; p = 0.0317). Kaplan-Meier survival plots showed DFS and OS of high risk group were significantly worse compared to those of low risk group (p = 0.0379 for DFS; p = 0.0211 for OS).
Conclusions
WBSUVmax was significantly associated with suboptimal cytoreduction. Furthermore, hypermetabolic lesions at central and both upper had predictive value for suboptimal cytoreduction.
Clinical trial identification
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Editorial Acknowledgement
Disclosure
All authors have declared no conflicts of interest.