Prognostic implication of the metastatic lesion-to-ovarian cancer standardised uptake value ratio in advanced serous epithelial ovarian cancer.

Abstract

To evaluate the prognostic value of metabolic activity of metastatic lesions measured by ¹⁸F-flurodeoxyglucose (¹⁸F-FDG) uptake on preoperative positron emission tomography/computed tomography (PET/CT) in patients with advanced serous epithelial ovarian cancer (EOC). Clinico-pathological variables and PET/CT parameters such as the maximum standardised uptake value of the ovarian cancer (SUV_ovary), metastatic lesions (SUV_meta), and the metastatic lesion-to-ovarian cancer standardised uptake value ratio (SUV_meta/SUV_ovary) were assessed in International Federation of Gynaecology and Obstetrics (FIGO) stage III, IV patients. Clinico-pathological data were retrospectively reviewed for 94 eligible patients. The median progression-free survival (PFS) was 18.5 months (range, 6-90 months), and 57 (60.6%) patients experienced recurrence. Older age [P = 0.017, hazard ratio (HR) 1.036, 95% CI 1.006-1.066], residual disease after surgery (P = 0.024, HR 1.907, 95% CI 1.087-3.346), and high SUV_meta/SUV_ovary (P = 0.019, HR 2.321, 95% CI 1.148-4.692) were independent risk factors of recurrence. Patients with high SUV_meta/SUV_ovary showed a significantly worse PFS than those with low SUV_meta/SUV_ovary (P = 0.007, log-rank test). Preoperative SUV_meta/SUV_ovary was significantly associated with recurrence and has an incremental prognostic value for PFS in patients with advanced serous EOC. • The prognostic value of the metabolic activity of metastatic lesions was investigated. • SUV_meta/SUV_ovary was significantly associated with recurrence of serous EOC. • Preoperative SUV_meta/SUV_ovary can be a predicator of serous EOC recurrence.