Usefulness of Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography in Prognosis of Primary Uterine Carcinosarcoma

Objective: To assess the prognostic value of metabolic parameters measured using preoperative 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) in patients with primary uterine carcinosarcoma (UCS). Methods: This retrospective cohort study included 20 Japanese women with UCS. Metabolic parameters of primary tumors, such as standard maximum uptake value (SUVmax), peak standardized uptake value (SUVpeak), metabolic tumor volume (MTV), and total lesion glycolysis (TLG), were analyzed with 18FFDG PET/CT software, and prognostic values of metabolic parameters were evaluated using progressionfree survival (PFS) and overall survival (OS). Results: The mean and standard deviation of the age of 20 enrolled patients was 65.5 ± 13.7 years and that of body mass index (BMI) was 22.6 ± 4.5 kg/m2. The log-rank test revealed significant differences in 5-year PFS and OS between groups with low and high MTV (P = 0.014 and P = 0.002, respectively). SUVmax, SUVpeak, and TLG did not show any significant differences in PFS or OS. The study data was used to calculate hazard ratios (HR) and 95% confidence intervals (CI). Increased MTV was associated with poorer PFS and OS in UCS (HR, 3.71; 95% CI, 1.71 – 58.47 and 5.39; 95% CI, 3.77 – 21.84, respectively) in the study’s 14 subgroups. Conclusion: MTV, which reflects tissue size and spread, may serve as a prognostic indicator in patients with UCS.