Do PET-positive supradiaphragmatic lymph nodes predict overall survival or the success of primary surgery in patients with advanced ovarian cancer?

Purpose: Compared with conventional CT, FDG-PET/CT detects a higher rate of lymph node and distant metastases in ovarian cancer patients. However, it is not currently routinely performed in the pre-operative work-up. Therefore, we investigated the prognostic value of a pre-operative FDG-PET/CT in advanced epithelial ovarian cancer (EOC) and its predictive value regarding surgical resection to no residual disease. Specifically, a potential significance of PET-positive supradiaphragmatic lymph nodes (SDLN) on these parameters was evaluated. Methods: All patients with FIGO IIA-IVB EOC diagnosed between 03/2014–01/2021 at our certified gynecological cancer center with a FDG PET/CT prior to primary surgical therapy were retrospectively included. Results: A total of consecutive 53 patients were included in the study. 18 (34%) had PET-positive SDLN. We could not demonstrate a significant correlation between PET-positive SDLN and median overall survival (OS; SDLN positive: 58.76 months, SDLN negative: 60.76 months; p = 0.137) or intra- and perioperative outcomes. Conclusion: In ovarian cancer, FDG PET/CT has a higher detection rate for SDLN compared to CT detection rates described in the literature. PET-positive SDLNs failed to predict the intraoperative outcome or overall survival.