Prognostic importance of peritoneal lesion-to-primary tumour standardized uptake value ratio in advanced serous epithelial ovarian cancer.

OBJECTIVES: Using preoperative PET/CT, we evaluated the prognostic value of preoperative [18 F]FDG uptake ratio between various metastatic lesions and primary tumour in patients with advanced serous epithelial ovarian cancer (EOC).

METHODS: We retrospectively reviewed patients with International Federation of Gynecology and Obstetrics (FIGO) stage III, IV serous EOC who underwent preoperative [18 F]FDG PET/CT scans. Clinico-pathological variables and PET/CT parameters such as maximum standardized uptake value of the ovarian cancer (SUVovary ), pelvic or para-aortic LN (SUVLN ), peritoneal (SUVperit ) and distant extra-peritoneal (SUVdist ) metastatic lesions, and the metastatic lesion-to-ovarian cancer standardized uptake value ratio were assessed.

RESULTS: Clinico-pathological data were retrospectively reviewed for 97 eligible patients. The median progression-free survival (PFS) was 18 months (range, 6-90 months) and 59 (60.8 %) patients experienced recurrence. In multivariate regression analysis, older age (p = 0.035, hazard ratio (HR) 1.032, 95 % CI 1.002-1.062), and high SUVperit /SUVovary (p = 0.046, HR 1.755, 95 % CI 1.011-3.047) were independent risk factors of recurrence. Patient group categorized by SUVperit /SUVovary showed significant difference in PFS (Log-Rank test, p = 0.001).

CONCLUSIONS: In patients with advanced serous EOC, preoperative SUVperit /SUVovary measured by [18 F]FDG PET/CT provides significant incremental performance for prediction of recurrence.

KEY POINTS: • PET/CT data from advanced serous epithelial ovarian cancer patients were analysed. • Prognostic value of SUV ratio between metastatic and primary tumour was investigated. • SUV perit /SUV ovary provides incremental performance for prediction of recurrence.