Department of Oncology, the Finsen Center, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
Gynecol Oncol. 2010 Mar;116(3):395-8. doi: 10.1016/j.ygyno.2009.12.008. Epub 2009 Dec 29.
To investigate if the use of diagnostic FDG-PET/CT leads to stage migration in patients with advanced ovarian cancer and to evaluate the prognostic significance of FDG-PET/CT.
From September 2004 to August 2007, 201 patients with a Risk of Malignancy Index (RMI) >150 based on serum CA-125, ultrasound examinations and menopausal state, underwent PET/CT within 2 weeks prior to standard surgery/debulking of a pelvic tumor. On 15 August, 2009 overall survival and prognostic variables were analysed in 66 ovarian cancer patients (64 stage III and 2 stage IV).
Median follow-up was 30.2 months; median age was 62.5 years (range 35-85 years); 97% (64/66) had a performance status <or=2; 38% (25/66) underwent complete debulking (no macroscopic residual tumor); 51% (39/66) was diagnosed with PET/CT stage III and 41% (27/66) was diagnosed with PET/CT stage IV. Survival was significantly longer for patients with PET/CT stage III than for patients with PET/CT stage IV (P=0.03). Using univariate analysis, PET/CT stage III (P=0.03), complete debulking (no macroscopic residual tumor) (P=0.002), and GOG performance status <or=2 (P=0.04) were statistically significant prognostic variables. Using multivariate Cox regression analysis, complete debulking was the only statistically significant independent prognostic variable (P=0.02).
In primary advanced ovarian cancer the use of diagnostic FDG-PET/CT leads to stage migration. Adequate staging is the foundation for ovarian cancer treatment and advanced imaging for optimal evaluation of metastases should be promoted in clinical trials. The strongest determinant of patient outcome is residual abdominal tumor after primary surgery.
研究在晚期卵巢癌患者中使用诊断性 FDG-PET/CT 是否会导致分期迁移，并评估 FDG-PET/CT 的预后意义。
从 2004 年 9 月至 2007 年 8 月，根据血清 CA-125、超声检查和绝经状态，201 名风险恶性指数（RMI）>150 的患者在标准的盆腔肿瘤手术/减瘤术之前的 2 周内进行了 PET/CT 检查。2009 年 8 月 15 日，对 66 名卵巢癌患者（64 名 III 期和 2 名 IV 期）的总生存和预后变量进行了分析。
中位随访时间为 30.2 个月；中位年龄为 62.5 岁（范围 35-85 岁）；97%（64/66）的表现状态<或=2；38%（25/66）行完全减瘤术（无肉眼残留肿瘤）；51%（39/66）被诊断为 PET/CT III 期，41%（27/66）被诊断为 PET/CT IV 期。PET/CT 分期为 III 期的患者生存时间明显长于 PET/CT 分期为 IV 期的患者（P=0.03）。使用单因素分析，PET/CT 分期 III 期（P=0.03）、完全减瘤术（无肉眼残留肿瘤）（P=0.002）和 GOG 表现状态<或=2（P=0.04）是统计学上显著的预后变量。使用多因素 Cox 回归分析，完全减瘤术是唯一统计学上显著的独立预后变量（P=0.02）。
在原发性晚期卵巢癌中，诊断性 FDG-PET/CT 的使用导致了分期迁移。充分的分期是卵巢癌治疗的基础，应在临床试验中推广先进的成像技术，以优化转移灶的评估。患者结局的最强决定因素是初次手术后的残余腹部肿瘤。
