Prognostic Value of Pretherapeutic Primary Tumour MTV from [18F]FDG PET in Radically Treated Cervical Cancer Patients

The aim of this study was to assess the usefulness of pretherapeutic primary tumor
metabolic tumor volume (MTV) in the prognosis of radically treated cervical cancer patients. Ret-
rospective, single-centre analysis was performed on a group of 508 cervical cancer patients. All
patients underwent a pretreatment [18 F]FDG PET/CT study for the assessment of the disease stage.
Several PET-derived parameters—namely, maximum standardized uptake value (SUVmax ), mean
standardized uptake value (SUVmean ), total lesion glycolysis (TLG) and MTV, as well as the clinical
parameters, were analysed in terms of the overall survival (OS), event-free survival (EFS), locore-
gional control (LRC) and freedom from distant metastases (FFDM). Hyperthermia and brachytherapy
were prognostic for EFS, OS, and LRC.FIGO stage > II showed a significant effect on EFS, OS, and
FFDM. Moreover, hysterectomy was prognostic for OS and histology was prognostic for FFDM. From
the PET-derived parameters only MTV of the primary tumour had a significant influence on OS
(cutoff point: >12.7 mL, HR: 2.8, 1.75–4.48 95% CI, p < 0.001), LRC (cutoff point: >13.7 mL, HR 2.82,
1.42–5.61 95% CI, p = 0.003), EFS (cutoff point: >10.4 mL, HR: 2.57, 1.67–3.97 95% CI, p < 0.001) and
FFDM (cutoff point: >10.4 mL, HR: 5.04, 1.82–13.99 95% CI, p = 0.002). The pretreatment of MTV
in primary tumour is the only independent prognostic parameter in OS, LRC, EFS, and FFDM in
radically treated cervical cancer patients and should be used in clinical practice in assessing prognosis