In:
International Journal of Gynecologic Cancer, BMJ, Vol. 22, No. 7 ( 2012-09), p. 1163-1169
Abstract:
To evaluate the role of 2-deoxy-2-( 18 F)fluoro-D-glucose (FDG) positron emission tomography/computed tomography (PET/CT) for selecting patients with extensive ovarian cancer (OC) for neoadjuvant chemotherapy by evaluating predictors of overall survival in patients with stage IIIC/IV OC. Materials and Methods From September 1, 2004, to November 20, 2011, 514 consecutive patients with a pelvic tumor underwent preoperative PET/CT; 179 patients had stage IIIC/IV OC. Patients’ characteristics were collected from 153 patients with stage IIIC/IV OC who underwent primary surgery. In 152 patients with stage IIIC/IV OC, clinical predictors and PET/CT predictors of survival were evaluated. Results Median age was 64 years (range, 38–88 years); 87% (113) of the 153 patients had a performance status of less than 2; 55% (84) of the 153 patients had PET/CT stage III, and 45% (69) of the 153 patients had PET/CT stage IV. Using univariate analysis, incomplete debulking ( P = 0.0001), pleural exudates ( P = 0.001), postmenopausal state ( P = 0.01), WHO performance status greater than 2 ( P = 0.01), PET/CT stage IV ( P = 0.01), and large bowel mesentery implants ( P = 0.02) were statistically significant prognostic variables. Using multivariate Cox regression analysis, incomplete debulking was the only statistically significant independent prognostic variable ( P = 0.0001). Median overall survival was significantly longer in the 53 patients with no residual tumor than in the 99 patients with residual tumor (33.3 vs 25.5 months; P = 0.0001) Conclusion Suggested PET/CT criteria for referral of patients with advanced OC to neoadjuvant chemotherapy are PET/CT stage IV, pleural exudates, and PET-positive large bowel mesentery implants. Evaluation of selection criteria for neoadjuvant chemotherapy should be promoted in prospective clinical trials, with survival as the primary end point.
Type of Medium:
Online Resource
ISSN:
1048-891X
,
1525-1438
DOI:
10.1097/IGC.0b013e3182606ecb
Language:
English
Publisher:
BMJ
Publication Date:
2012
detail.hit.zdb_id:
2009072-9
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