TITLE:
Prognostic Significance of Fluorodeoxyglucose Positron Emission Tomography Maximum Standardized Uptake Value in Stage I Ovarian Clear Cell Carcinoma: A Retrospective Observational Study
AUTHORS:
Haruhisa Konishi, Kazuhiro Takehara, Shinichi Okame, Masaaki Komatsu, Yuko Shiroyama, Takashi Yokoyama, Yoshifumi Sugawara
KEYWORDS:
Ovarian Clear Cell Carcinoma, FDG-PET/CT, SUVmax, Biomarker, Prognosis
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.6 No.2,
February
26,
2016
ABSTRACT: Background: Ovarian clear cell carcinoma (CCC) is
often diagnosed at stage I. However, because of the poor prognosis of recurrent
cases, even for stage Ia CCC, treatment strategies such as expansion of
fertility-sparing treatment and omission of adjuvant chemotherapy have been
carefully discussed in recent years. We previously reported the possibility of
the maximum standardized uptake value (SUVmax) as a biomarker of CCC prognosis
prediction at all stages. In this study, we confirmed differences in SUVmax
within stage I CCC and considered treatment strategies. Methods: We selected
all 31 patients with ovarian CCC stage I who underwent fluorodeoxyglucose
positron emission tomography/computed tomography (FDG-PET/CT) before treatment
between 2006 and 2013 at our institution. This retrospective study was based on
their medical records. Results: Clinical tumor stage was Ia in 13 patients, and
Ic in 18 (Ic (b) in 11, and Ic (1) + Ic (2) in seven). There were no
differences in serum CA125 level, maximum tumor diameter or mural nodules.
Median SUVmax was significantly higher in stage Ic (5.87) than stage Ia (3.08)
cases (P = 0.02). Progression-free
survival was longer in the low SUVmax group than the high SUVmax group (P = 0.08). Conclusions: SUVmax for
primary lesions in CCC was significantly higher in stage Ic than stage Ia. As
SUVmax represents a prognostic factor in stage I CCC, these findings may
suggest SUVmax as an indicator for the application of fertility-sparing surgery
and omission of adjuvant chemotherapy for stage Ia CCC.