BackgroundGlucose metabolism has been suggested as a therapeutic target in ovarian clear cell carcinoma (CCC). We attempted to clarify F-18-FDG PET/CT-based metabolic metrics in the recurrent ovarian CCC patients and their prognostic values.MethodsQuantitative metabolic parameters included maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV) and total lesion glycolysis (TLG). Two different methods were employed for defining the threshold SUV to delineate MTV: 1) SUV of 2.5 (designated as MTV); 2) a fixed ratio including 40% (MTV40), 50% (MTV50) and 60% (MTV60) of SUVmax. The Kaplan-Meier model and Cox regression were used in survival analysis.ResultsAmong the 35 patients, platinum-resistant recurrence accounted for 34.3% and the median progression-free survival was 13months (range, 2-135). Fifteen (42.9%) patients presented with single tumor recurrence, while 51 recurrent lesions were identified, with the most common sites in pelvis (29.4%), followed by lymph node metastases (19.6%) and peritoneal carcinomatosis (15.7%). Except four patients with FDG-inavid tumor, the median SUVmax of the 31 patients with high glucose metabolic activity was 7.10 (range, 3.00-20.60). After a median follow-up of 36.5months (range, 7-155), 22 patients (64.7%) were dead from disease. The median post-relapse survival (PRS) was 17months (range, 4-126). Platinum-resistant recurrence, peritoneal carcinomatosis and high TLG60 proved to be negative predicators of overall survival after multivariate analysis.ConclusionsTLG60, platinum-resistant recurrence and peritoneal carcinomatosis were independent negative predicators of overall survival. Whether patients with higher TLG60 required more aggressive treatment warranted further study.
[1]Fudan Univ, Shanghai Canc Ctr, Dept Gynecol Oncol, Shanghai 200032, Peoples R China;
[2]Fudan Univ, Shanghai Canc Ctr, Dept Nucl Med, Shanghai, Peoples R China;
[3]Fudan Univ, Shanghai Med Coll, Dept Oncol, Shanghai 200032, Peoples R China
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