Preoperative PET/CT score can predict incomplete resection after debulking surgery for advanced serous ovarian cancer better than CT score, MTV, tumor markers and hematological markers

Abstract

Introduction: Complete resection after debulking surgery is strongly associated with prolonged survival for advanced serous ovarian cancer (ASOC). Though positron emission tomography/computed tomography (PET/CT) is more advantageous than computed tomorgraphy (CT) for detecting metastases, studies on the PET/CT prediction model for incomplete resection for ovarian cancer are insufficient. We analyzed and compared the predictive value of preoperative PET/CT score, CT score, metabolic parameters, tumor markers and hematological markers for incomplete resection after debulking surgery for ASOC. Material and methods:A total of 62 ASOC patients who underwent preoperative [ 18 F]FDG PET/CT and debulking surgery were retrospectively analyzed. PET/CT and CT scores were based on the Suidan model. The predictive value of PET/CT score, CT score, the maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), human epididymis protein 4 (HE4), cancer antigen 125 (CA125), lymphocyteto-monocyte ratio (LMR), platelet-to-lymphocyte ratio (PLR) and neutrophil-tolymphocyte ratio (NLR) for incomplete resection were analyzed and compared. Results: Preoperative PET/CT score had the highest predictive value for incomplete resection in primary debulking surgery group (sensitivity: 65.0%, specificity: 88.9%, area under the ROC curve (AUC): 0.847, p < 0.001), however, in secondary debulking surgery group, preoperative PET/CT score and CT score had the same and highest predictive value for incomplete resection (sensitivity: 80.0%, specificity: 94.7%, AUC: 0.853, p = 0.017), compared with preoperative metabolic parameters SUVmax and MTV, tumor markers HE4 and CA125, and hematological markers LMR, PLR and NLR. Preoperative PET/CT score ≥ 3 (Suidan model) and preoperative PET/CT score ≥ 2 predicted a high risk of incomplete resection after primary and secondary debulking We retrospectively analyzed patients with ASOC at our hospital from July 1, 2015 to January 31, 2022 (stages III-IV according to the International Federation of Gynecology and Obstetrics [FIGO]surgeries, respectively. There was no statistical difference between primary and secondary debulking surgery groups in predictive value of PET/CT score for incomplete resection (p = 0.971). There were significant differences between PET/CT scores and CT scores in primary debulking surgery group and no significant differences in secondary debulking surgery group.Conclusions: A high PET/CT score predicted a high risk of incomplete resection. The preoperative PET/CT score had an identical predictive value in primary and secondary debulking surgery groups. PET/CT score was more accurate in the detection of metastases than CT score was.

New Prognostic Index for Neoadjuvant Chemotherapy Outcomes in Patients with Advanced High-Grade Serous Ovarian Cancer

“…We therefore developed a ONCPI score, a combined index integrating NLR and CRS to predict prognostic value in neoadjuvant-treated advanced HGSOC patients. Previous studies have explored various combined indexes to predict the prognosis of ovarian cancer, typically integrating NLR with tumor and hematological markers or radiological data, such as the CA-125, PLR, SII and PET/CT or MRI characteristics [5,24,25]. Although these combined indexes have demonstrated their influence on disease progression and response to treatment, it is rare to find an index that encompasses both blood inflammatory composite markers and pathology index in specific patients.…”

The OCDA-Net: a 3D convolutional neural network-based system for classification and staging of ovarian cancer patients using [18F]FDG PET/CT examinations

“…Almost 70-80% of OC patients show recurrence of the disease despite proper rst-line chemotherapy and optimal surgery. Recurrence occurs in 23% of cases within or during 6 months following the ending of primary chemotherapy, and it is 60% after 6 months [3][4][5]. Therefore, it is required to apply an accurate noninvasive follow-up method to follow-up patients with OC.…”