Utility of the maximum standardized uptake value on positron emission tomography for predicting therapeutic effect in recurrent gynecological malignancies: A preliminary study.

AIM: The maximum standardized uptake value (SUVmax) of primary tumors in positron emission tomography can be used to predict prognosis in various cancers, but its significance in recurrent tumors remains unclear. In the present study, we evaluated the utility of the SUVmax for predicting therapeutic effects in recurrent gynecological malignancies.

METHODS: From February 2012 to July 2014, patients with recurrent gynecological cancer who were treated with chemotherapy or radiotherapy were enrolled in this study. The SUVmax of recurrent lesions before treatment were compared to the therapeutic effects.

RESULTS: Fifty patients with recurrent gynecological cancer were enrolled. The mean SUVmax was significantly higher in patients with stable disease/progressive disease than in patients who achieved complete remission/partial remission (13.24 ± 9.78 vs 8.61 ± 5.34, P = 0.039). In patients who were administered chemotherapy, the SUVmax was significantly higher in those with stable disease/progressive disease than in those who achieved complete remission/partial remission (13.24 ± 9.78 vs 8.61 ± 5.34, P = 0.0392) as well as those administered radiotherapy or concurrent chemoradiation therapy (18.15 ± 3.25 vs 11.33 ± 3.98, P = 0.0073). In ovarian cancer patients administered chemotherapy, when the cut-off value of the SUVmax was set as 6.94, the sensitivity and specificity of predicting therapeutic effects were 0.75 and 0.846, respectively.

CONCLUSION: Although the number of enrolled cases was small, our study revealed that the SUVmax in recurrent gynecological tumors might predict therapeutic effects. If the SUVmax is relatively high, multimodal therapy, including surgical removal, should be considered.