18 F-FDG PET/CT-based metabolic metrics in recurrent tumors of ovarian clear cell carcinoma and their prognostic implications

Shuang Ye, Shuai Liu, Libing Xiang, Xiaohua Wu, Huijuan Yang

Research output: Contribution to journalArticle

Abstract

Background: Glucose metabolism has been suggested as a therapeutic target in ovarian clear cell carcinoma (CCC). We attempted to clarify 18 F-FDG PET/CT-based metabolic metrics in the recurrent ovarian CCC patients and their prognostic values. Methods: Quantitative 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. Results: Among the 35 patients, platinum-resistant recurrence accounted for 34.3% and the median progression-free survival was 13 months (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 36.5 months (range, 7-155), 22 patients (64.7%) were dead from disease. The median post-relapse survival (PRS) was 17 months (range, 4-126). Platinum-resistant recurrence, peritoneal carcinomatosis and high TLG60 proved to be negative predicators of overall survival after multivariate analysis. Conclusions: TLG60, 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.

Original languageEnglish (US)
Article number226
JournalBMC cancer
Volume19
Issue number1
DOIs
StatePublished - Mar 13 2019

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Carcinoma
Recurrence
Platinum
Tumor Burden
Neoplasms
Survival
Glucose
Glycolysis
Survival Analysis
Pelvis
Proportional Hazards Models
Disease-Free Survival
Multivariate Analysis
Lymph Nodes
Neoplasm Metastasis
Therapeutics

Keywords

  • Clear cell carcinoma
  • Ovarian neoplasms
  • Positron emission tomography computed tomography
  • Recurrence
  • Survival

ASJC Scopus subject areas

  • Oncology
  • Genetics
  • Cancer Research

Cite this

18 F-FDG PET/CT-based metabolic metrics in recurrent tumors of ovarian clear cell carcinoma and their prognostic implications . / Ye, Shuang; Liu, Shuai; Xiang, Libing; Wu, Xiaohua; Yang, Huijuan.

In: BMC cancer, Vol. 19, No. 1, 226, 13.03.2019.

Research output: Contribution to journalArticle

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abstract = "Background: Glucose metabolism has been suggested as a therapeutic target in ovarian clear cell carcinoma (CCC). We attempted to clarify 18 F-FDG PET/CT-based metabolic metrics in the recurrent ovarian CCC patients and their prognostic values. Methods: Quantitative 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. Results: Among the 35 patients, platinum-resistant recurrence accounted for 34.3{\%} and the median progression-free survival was 13 months (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 36.5 months (range, 7-155), 22 patients (64.7{\%}) were dead from disease. The median post-relapse survival (PRS) was 17 months (range, 4-126). Platinum-resistant recurrence, peritoneal carcinomatosis and high TLG60 proved to be negative predicators of overall survival after multivariate analysis. Conclusions: TLG60, 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.",
keywords = "Clear cell carcinoma, Ovarian neoplasms, Positron emission tomography computed tomography, Recurrence, Survival",
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AU - Ye, Shuang

AU - Liu, Shuai

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AU - Wu, Xiaohua

AU - Yang, Huijuan

PY - 2019/3/13

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N2 - Background: Glucose metabolism has been suggested as a therapeutic target in ovarian clear cell carcinoma (CCC). We attempted to clarify 18 F-FDG PET/CT-based metabolic metrics in the recurrent ovarian CCC patients and their prognostic values. Methods: Quantitative 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. Results: Among the 35 patients, platinum-resistant recurrence accounted for 34.3% and the median progression-free survival was 13 months (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 36.5 months (range, 7-155), 22 patients (64.7%) were dead from disease. The median post-relapse survival (PRS) was 17 months (range, 4-126). Platinum-resistant recurrence, peritoneal carcinomatosis and high TLG60 proved to be negative predicators of overall survival after multivariate analysis. Conclusions: TLG60, 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.

AB - Background: Glucose metabolism has been suggested as a therapeutic target in ovarian clear cell carcinoma (CCC). We attempted to clarify 18 F-FDG PET/CT-based metabolic metrics in the recurrent ovarian CCC patients and their prognostic values. Methods: Quantitative 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. Results: Among the 35 patients, platinum-resistant recurrence accounted for 34.3% and the median progression-free survival was 13 months (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 36.5 months (range, 7-155), 22 patients (64.7%) were dead from disease. The median post-relapse survival (PRS) was 17 months (range, 4-126). Platinum-resistant recurrence, peritoneal carcinomatosis and high TLG60 proved to be negative predicators of overall survival after multivariate analysis. Conclusions: TLG60, 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.

KW - Clear cell carcinoma

KW - Ovarian neoplasms

KW - Positron emission tomography computed tomography

KW - Recurrence

KW - Survival

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