Predictive value of PET metabolic parameters for occult lymph node metastases in PET/CT defined node-negative patients with advanced epithelial ovarian cancer

Abstract

Accurate lymph node metastasis (LNM) prediction is crucial for patients with advanced epithelial ovarian cancer (AEOC) since it guides the decisions about lymphadenectomy. Many previous studies showed that occult lymph node metastasis was common in AEOC. The objective of our study is to quantitatively assess the probability of occult lymph node metastasis (OLNM) defined by 18F-Fluorodeoxyglucose (FDG) PET/CT in AEOC and explore relationship between ONNM and PET metabolic parameters. The patients with pathologically confirmed AEOC who underwent PET/CT for preoperative staging at our institute were reviewed. Univariate and multivariate analyses were performed to evaluate the predictive value of PET/CT-related metabolic parameters for OLNM. The result of our study showed metastatic TLG index had a better diagnostic performance than other PET/CT-related metabolic parameters. Two variables were independently and significantly associated with OLNM in multivariate analysis: metastatic TLG index and primary tumor location. The logistic model combining metastatic TLG index and primary tumor location might be a promising tool to effectively predict the individualized possibility of OLNM for AEOC patients.