Prognostic Value of PET-CT on Survival Outcomes in Patients with Advanced Ovarian Cancer

Positron emission tomography–computed tomography (PET-CT) is a noninvasive imaging tool used in the detection of recurrent ovarian cancer and the management of patients with ovarian cancer. Researchers sought to examine whether performing early preoperative PET-CT in patients with ovarian cancer undergoing neoadjuvant chemotherapy may provide useful information about response to treatment and prognosis in these patients.

A prospective observational study of patients diagnosed with advanced-stage ovarian cancer was performed between September 2014 and May 2016. Only patients who were considered ineligible for primary debulking surgery were included. Patients had been treated with 4 cycles of neoadjuvant chemotherapy with paclitaxel and carboplatin, followed by interval debulking and 3 additional cycles of chemotherapy. Patients were evaluated with PET-CT between the initiation of chemotherapy, the first cycle, and the fourth cycle. Primary outcomes were standardized uptake value, metabolic tumor volume, and tumor lesion glycolysis. These parameters were compared between patients with and without recurrence and cancer-related death and correlated with overall survival and disease-free survival.

A total of 10 patients were recruited for the study. Complete excision of disease was achieved in all patients. In patients with later cancer-related death, maximum standardized uptake value reduced by 45.9% compared with 8.0% in survivors. Similarly, the tumor lesion glycolysis reduction between initiation of chemotherapy and the first cycle was 76.51% in patients with later cancer-related death compared with 33.7% in survivors. However, patients without disease recurrence had significantly higher tumor lesion glycolysis reduction between cycles 1 and 4, with 95.0% reduction compared with 69.1% in patients with recurrence. All mean values of PET-CT parameters demonstrated a greater reduction between cycles 1 and 4 in patients without disease recurrence.

Researchers conclude that early preoperative PET-CT examination in patients with advanced-stage ovarian cancer may hold prognostic value. Further studies with a larger sample size may better assess the precise role of PET-CT in the preoperative triage of patients with advanced ovarian cancer.

Abstract 486. ESGO 2020.

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