Metabolic tumor volume by 18 F-FDG PET/CT is prognostic for stage IVB endometrial carcinoma

ObjectiveThe objective of this study was to evaluate the potential prognostic factors in patients with primary stage IVB endometrial carcinoma, incorporating parameters from 18 F-FDG PET/CT such as standardized uptake value (SUV), metabolic tumor volume (MTV), and total lesion glycolysis (TLG).MethodsPatients with primary M1 endometrial carcinoma who received 18 F-FDG PET/CT before treatment were retrospectively analyzed. Histological type, histological grade, T stage, N stage, age, ECOG performance status, hormone receptor status, metastatic patterns, number of involved metastatic patterns, serum CA125 level, and 18 F-FDG PET/CT derived parameters including total body SUVmax, total body MTV, and total body TLG were considered as potential prognostic factors for overall survival. Cox proportional hazards regression model was used for statistical analysis.ResultsFifteen patients were eligible with a median survival of 17 months. Total body MTV and total body TLG were highly collinear (Pearson's r = 0.978) and were found to be significant prognosticators (P = 0.010 and 0.011 respectively). Four patients with total body MTV above 450 mL (or total body TLG above 2700 g) had a median survival of two months, while the remaining patients had a median survival of 47 months.ConclusionTotal body MTV is a significant prognostic factor for overall survival in patients with stage IVB endometrial carcinoma. Patients with total body MTV above 450 mL had a very poor survival, while more aggressive therapy may be considered in the remaining patients in pursuit of prolonged survival.

► Metabolic tumor volume by 18 F-FDG PET/CT was found to be prognostic for stage IVB endometrial carcinoma.
► Patients with total body MTV above 450 mL had a very poor survival.
► Patients with total body MTV below 450 mL may receive more aggressive therapy in pursuit of prolonged survival.