Department of Obstetrics and Gynecology, School of Medicine, Kyungpook National University, Daegu, 41944, Republic of Korea.
Molecular Diagnostics and Imaging Center, School of Medicine, Kyungpook National University, Daegu, 41944, Republic of Korea.
J Ovarian Res. 2019 Feb 4;12(1):12. doi: 10.1186/s13048-019-0488-2.
The aim of this study was to (1) evaluate the ability of F-18 fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) parameters to predict suboptimal cytoreduction and (2) to create a risk model for predicting suboptimal cytoreduction in advanced ovarian cancer. From 2011 to 2015, 51 patients underwent primary cytoreductive surgery for advanced ovarian cancer were enrolled. A residual disease with maximal diameter > 1 cm was considered a suboptimal surgical result. The SUVmax values for nine abdominal regions, the sum of 9 regional SUVmax (WB1SUVmax) and WB2SUVmax (WB1SUVmax plus SUVmax of lymph nodes) were used for PET parameter. Multiple logistic regression analysis was used to determine the predictive value of PET and clinical parameters for risk model. In addition, assessments of disease-free survival (DFS) and overall survival (OS) were performed.
Seventeen of the 51 patients (33.3%) underwent suboptimal cytoreduction. The ECOG status (OR, 4.091), SUVmax of central (OR, 5.250), right upper (OR, 4.148), left upper (OR, 5.921) and WB2SUVmax (OR, 4.148) were associated with suboptimal cytoreduction. The risk model can divide the risk groups of suboptimal cytoreduction (area under the curve (AUC), 0.775; p = 0.0001). The DFS and OS in the high-risk group were significantly worse than those in the low-risk group (p = 0.0379 for DFS; p = 0.0211 for OS).
The presence of hypermetabolic lesions in the central, right upper, and left upper regions showed predictive value for suboptimal cytoreduction. Our risk model may be helpful for selecting patients who may show suboptimal cytoreduction.
本研究旨在：（1）评估 18F 氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（FDG PET/CT）参数预测不完全肿瘤减灭术的能力，（2）建立预测晚期卵巢癌不完全肿瘤减灭术的风险模型。2011 年至 2015 年，51 例晚期卵巢癌患者接受了初次细胞减灭术。最大直径＞1cm 的残留疾病被认为是手术结果不理想。9 个腹部区域的 SUVmax 值、9 个区域 SUVmax 的总和（WB1SUVmax）和 WB2SUVmax（WB1SUVmax 加淋巴结 SUVmax）用于 PET 参数。采用多因素逻辑回归分析确定 PET 和临床参数对风险模型的预测价值。此外，还进行了无病生存（DFS）和总生存（OS）评估。
51 例患者中有 17 例（33.3%）接受了不完全肿瘤减灭术。ECOG 状态（OR，4.091）、中央（OR，5.250）、右上（OR，4.148）、左上（OR，5.921）和 WB2SUVmax（OR，4.148）与不完全肿瘤减灭术相关。风险模型可以将不完全肿瘤减灭术的风险组（曲线下面积（AUC），0.775；p=0.0001）。高危组的 DFS 和 OS 明显差于低危组（DFS 时 p=0.0379；OS 时 p=0.0211）。
中央、右上和左上区域的高代谢病变存在对不完全肿瘤减灭术具有预测价值。我们的风险模型可能有助于选择可能表现为不完全肿瘤减灭术的患者。
