The measurement of SUVmax of the primary tumor is predictive of prognosis for patients with endometrial cancer.

OBJECTIVE The purpose of this study was to evaluate if preoperative measurements of the maximum standardized uptake valve (SUVmax) on positron emission tomography/computed tomography (PET/CT) and tumor marker CA125 are correlated with clinical characteristics and prognosis in patients with endometrial cancer. METHODS The distribution of cases that scored positive for each of the biological parameters examined and the correlations with the SUVmax of the primary tumor and the serum tumor marker CA125 were examined for 106 patients with preoperative assessment of primary endometrial cancer. RESULTS There were significant correlations between the SUVmax of the primary tumor and the FIGO stage (P=0.030), histology (P=0.025), depth of myometrial invasion (P=0.031) and tumor maximum size (P<0.001). The serum CA125 level was significantly associated with the FIGO stage (P=0.050). The disease-free survival (DFS) and overall survival (OS) rates of patients exhibiting a high SUVmax of the primary tumor were significantly lower than those of patients exhibiting a low SUVmax of the primary tumor (P=0.049, and P=0.039, respectively). Furthermore, the DFS and OS rates of patients exhibiting a high SUVmax of the primary tumor were significantly lower than those of patients exhibiting a low SUVmax of the primary tumor at advanced stages (stages III-IV) (P=0.032 and P=0.023, respectively). In particular, the SUVmax of the primary tumor was an independent prognostic factor for OS by a multivariate analysis (P=0.025). CONCLUSIONS The present findings indicate that for patients with endometrial cancer, a high preoperative SUVmax of the primary tumor is an important predictive factor for identifying endometrial cancer patients with a poor prognosis.

[1]  Serum CA-125 Level after 6 Cycles of Primary Adjuvant Chemotherapy Is a Useful Prognostic Factor for Complete Responders’ Survival in Patients with Advanced Epithelial Ovarian Cancer , 2008, Oncology Research and Treatment.

[2]  S. Gambhir Molecular imaging of cancer with positron emission tomography , 2002, Nature Reviews Cancer.

[3]  D. Wood,et al.  Lung cancer proliferation correlates with [F-18]fluorodeoxyglucose uptake by positron emission tomography. , 2000, Clinical cancer research : an official journal of the American Association for Cancer Research.

[4]  R. Kurman,et al.  Relationship between surgical-pathological risk factors and outcome in clinical stage I and II carcinoma of the endometrium: A gynecologic oncology group study , 1991 .

[5]  R. Burger,et al.  Value of Preoperative CA 125 Level in the Management of Uterine Cancer and Prediction of Clinical Outcome , 1997, Obstetrics and gynecology.

[6]  S. Broste,et al.  Prognostic Significance of Gross Myometrial Invasion With Endometrial Cancer , 1996, Obstetrics and gynecology.

[7]  Torsten Mattfeldt,et al.  FDG uptake in breast cancer: correlation with biological and clinical prognostic parameters , 2002, European Journal of Nuclear Medicine and Molecular Imaging.

[8]  Y. Hirai,et al.  Combined assay of serum levels of CA125 and CA19-9 in endometrial carcinoma. , 1994, Gynecologic oncology.

[9]  Peter A S Johnstone,et al.  FDG-PET in radiotherapy treatment planning: Pandora's box? , 2004, International journal of radiation oncology, biology, physics.

[10]  P. Rose,et al.  Serial Serum CA 125 Measurements for Evaluation of Recurrence in Patients With Endometrial Carcinoma , 1994, Obstetrics and gynecology.

[11]  G. Fleuren,et al.  CA 125: a useful marker in endometrial carcinoma. , 1986 .

[12]  H. Chung,et al.  Post-treatment [18F]FDG maximum standardized uptake value as a prognostic marker of recurrence in endometrial carcinoma , 2010, European Journal of Nuclear Medicine and Molecular Imaging.

[13]  C. Snyderman,et al.  Combined PET-CT in the head and neck: part 2. Diagnostic uses and pitfalls of oncologic imaging. , 2005, Radiographics : a review publication of the Radiological Society of North America, Inc.

[14]  G. Fleuren,et al.  Tumor Markers CA 125, Squamous Cell Carcinoma Antigen, and Carcinoembryonic Antigen in Patients With Adenocarcinoma of the Uterine Cervix , 1989, Obstetrics and gynecology.

[15]  S. Kanazawa,et al.  The SUVmax of 18F-FDG PET Correlates With Histological Grade in Endometrial Cancer , 2009, International Journal of Gynecologic Cancer.

[16]  A. Jemal,et al.  Cancer Statistics, 2010 , 2010, CA: a cancer journal for clinicians.

[17]  L. Lagasse,et al.  Prognosis and treatment of endometrial cancer. , 1980, American journal of obstetrics and gynecology.

[18]  A. Alavi,et al.  Use of a corrected standardized uptake value based on the lesion size on CT permits accurate characterization of lung nodules on FDG-PET , 2002, European Journal of Nuclear Medicine and Molecular Imaging.

[19]  K. Togashi,et al.  Clinical value of positron emission tomography with FDG for recurrent ovarian cancer. , 2001, AJR. American journal of roentgenology.

[20]  F. Abdul-Karim,et al.  Positive emission tomography for evaluating a complete clinical response in patients with ovarian or peritoneal carcinoma: correlation with second-look laparotomy. , 2001, Gynecologic oncology.

[21]  D. Gal,et al.  Lymphvascular space involvement--a prognostic indicator in endometrial adenocarcinoma. , 1991, Gynecologic oncology.

[22]  R. Bast,et al.  Preoperative evaluation of serum CA 125, TAG 72, and CA 15-3 in patients with endometrial carcinoma. , 1990, American journal of obstetrics and gynecology.

[23]  Y. Yonekura,et al.  Expression of GLUT‐1 glucose transfer, cellular proliferation activity and grade of tumor correlate with [F‐18]‐fluorodeoxyglucose uptake by positron emission tomography in epithelial tumors of the ovary , 2004, International journal of cancer.

[24]  V. Abeler,et al.  Recurrent adenocarcinoma of the endometrium: a clinical and histopathological study of 379 patients. , 1984, Gynecologic oncology.

[25]  B. Bundy,et al.  Surgical pathologic spread patterns of endometrial cancer: A gynecologic oncology group study , 1987, Cancer.

[26]  J A Blessing,et al.  Surgical Staging in Endometrial Cancer: Clinical—Pathologic Findings of a Prospective Study , 1984, Obstetrics and gynecology.