Purpose: To determine if the preoperative maximum standardized uptake value (SUVmax) measured by [(18)F]FDG PET/CT has prognostic value in patients with endometrial cancer.
Methods: A total of 57 patients with FIGO stage I-IV endometrial cancer underwent FDG PET/CT imaging before radical surgery. SUVmax of the primary tumour was compared with histological prognostic factors, and the relationship between SUVmax and recurrence was examined.
Results: The median duration of follow-up was 33.1 months (range 4 to 68 months). SUVmax was significantly higher in patients with a higher FIGO stage (p = 0.0015), higher tumour histological grade (p < 0.0001), myometrial invasion (p = 0.0020), larger tumour size (p = 0.0056) and lymph node metastasis (p = 0.027). Univariate analysis showed that SUVmax (uncategorized value), FIGO stage, tumour histological grade, lymph node metastasis and lymphovascular space invasion were significantly associated with recurrence. However, multivariate analysis showed that only SUVmax (p = 0.045, hazard ratio 1.11, 95% CI 1.0028-1.231) was significantly associated with recurrence. Based on ROC curve analysis and log-rank tests, patients with a high a SUVmax (≥ 12.7) had a significantly lower disease-free survival rate than those with a low SUVmax (<12.7; p = 0.00042).
Conclusion: Preoperative FDG uptake by the primary tumour is significantly associated with recurrence in patients with endometrial cancer.