Maximum standardized uptake value (SUVmax) as prognostic factor for surgical cytoreduction and response to adjuvant chemotherapy in women submitted to 18F-FDG PET/CT for staging of advanced epithelial ovarian cancer (aEOC)

Objectives: after surgical cytoreduction, residual tumor (RT) and response to adjuvant treatment are prognostic factors in patients (pts) affected by aEOC. Aim of this work was to investigate the value of SUVmax in predicting clinical outcomes in this type of disease. Methods: 33 pts (mean age±SD 54.4±11.4 yrs) with FIGO advanced stage (29 III, 4 IV) EOC (21 serous, 5 endometrioid, 4 undifferentiated, 2 mucinous, 1 clear cells) submitted to PET/CT before surgical staging were retrospectively included. In each pt the highest SUVmax among all pathological sites of uptake detected in PET/CT was recorded. SUVmax values were compared to RT after cytoreductive surgery and to clinical response after adjuvant chemotherapy (complete response (CR) versus partial response (PR) or progression of disease (PD)). Results: globally mean±SD SUVmax was 13.4±5.6. After primary surgery in 21/33 (63.6%) pts with RT5 cm and in 12/33 (36.4%) with RT>5 cm mean±SD SUVmax values were 11.1±4.6 and 17.6±4.9 (p=0.0003), respectively. In 14/33 (42.4%) pts with RT 1 cm and in 19/33 (57.6%) with RT>1 cm mean±SD SUVmax values were 11.3±4.9 and 15±5.6 (p=0.0298), respectively. After adjuvant chemotherapy 18/33 (54.5%) pts and 15/33 (45.5%) achieved CR and PR/PD respectively; mean±SD SUVmax values were 11.8±4.4 and 15.4±6.4 (p=0.03). Conclusions: in aEOC presurgical SUVmax showed a correlation with clinical prognostic factors as residual tumor and response to adjuvant treatment. Metabolic parameters may play a role in prognostic stratification before treatment in pts with aEOC