prognostic value of pretreatment fdg pet/ct in uterine cervical cancer according to two major histologic types: squamous cell carcinoma and adenocarcinoma

Objective(s): the aim of this study was to assess the prognostic value of pretreatment positron emission tomography / computed tomography using 18f-fluorodeoxyglucose (fdg-pet/ct) in cervical cancer according to two major histologic types.methods: eighty-three squamous cell carcinoma (scc) patients and 35 adenocarcinoma (ac) patients who underwent pretreatment fdg-pet/ct were retrospectively analyzed. maximum standardized uptake value (suvmax), mean standardized uptake value (suvmean), metabolic tumor volume (mtv), and total lesion glycolysis (tlg) of the primary tumor were calculated. kaplan-meier analyses were used to compare correlations between each pet parameter and overall survival (os). the prognostic values of imaging and clinical parameters were assessed using uni- and multivariable cox proportional hazard models.results: suvmax, suvmean, and tlg were significantly higher in scc than in ac (p<0.01 each). no significant difference in mtv was seen between the two groups (p=0.10). as for kaplan-meier analyses, in scc, patients with suvmax, suvmean, mtv, and tlg exceeding cutoff values tended to show worse os than patients with lower values (p=0.07, p=0.27, p<0.01, and p=0.01, respectively, for os). on the other hand, in ac, patients with mtv and tlg exceeding cutoff values showed significantly worse pfs and os (p<0.01 each for os), while suvmax and suvmean were unrelated to os (p=0.91 and p=0.83, respectively for os). as for multivariable analyses, in scc, tlg was identified as an independent prognostic factor for os (p=0.01). in ac, mtv was identified as an independent prognostic factor for os (p=0.02).conclusion: our preliminary data suggest that fdg-pet/ct would be useful for predicting prognosis in cervical cancer, although the clinical significance of quantitative values may differ according to histopathological type.