Preoperative 18F-FDG PET/CT in the management of advanced epithelial ovarian cancer

Robert Fruscio, Federica Sina, Carlotta Dolci, Mauro Signorelli, Cinzia Crivellaro, Tiziana Dell'Anna, Marco Cuzzocrea, Luca Guerra, Rodolfo Milani, Cristina Messa

Research output: Contribution to journalArticlepeer-review

Abstract

Objective The introduction of 18-FDG-PET/CT during preoperative evaluation of patients with epithelial ovarian cancer (EOC) has led to an increase of the detection of extra-abdominal metastases. However, the clinical impact of this upstage remains unclear. Methods Patients with suspected advanced EOC underwent 18-FDG-PET/CT within two weeks prior to debulking surgery. Results Between 2006 and 2011 95 patients met the inclusion criteria. Based on the concordance or the discrepancy of clinical and PET/CT stage, patients were divided into 3 groups (A: clinical and PET III; B: clinical III and PET IV; C: clinical and PET IV). Twenty-five patients were upstaged from FIGO stage III to stage IV by PET/CT. The proportion of patients who achieved a residual tumor <1 cm in group B and C was similar, whereas it was significantly lower compared to group A. Similarly, complete response to adjuvant chemotherapy was achieved more frequently in patients in group A. PFS was similar in the three groups (17, 17 and 12 months in group A, B and C), as well as OS (51, 41 and 35 months). Conclusions PET/CT is able to detect distant metastases in EOC patients. The presence of extra-abdominal disease probably indicates a more aggressive disease which also shows a lower response to standard chemotherapy. However, upstaged patients have a similar prognosis compared to stage III patients, probably because intra-abdominal disease is more likely to lead patients to death. This might also explain why residual tumor is the most important prognostic factor for advanced EOC patients.

Original languageEnglish
Pages (from-to)689-693
Number of pages5
JournalGynecologic Oncology
Volume131
Issue number3
DOIs
Publication statusPublished - Dec 2013

Keywords

  • 18F-FDG PET/CT
  • Diagnosis
  • Epithelial ovarian cancer

ASJC Scopus subject areas

  • Obstetrics and Gynaecology
  • Oncology

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