Prognostic value of metabolic parameters on preoperative 18F-Fluorodeoxyglucose positron emission tomography/ computed tomography in patients with stage III gastric cancer
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Sae Jung Na1, Joo Hyun O2, Jae Myung Park3, Han Hee Lee2, Sung Hak Lee4, Kyo Young Song5, Myung-Gyu Choi2, Cho Hyun Park5
1Department of Radiology, The Catholic University of Korea, Uijeongbu St. Mary’s Hospital, Seoul, Korea
2Department of Radiology, The Catholic University of Korea, Seoul St. Mary’s Hospital, Seoul, Korea
3Department of Internal Medicine, The Catholic University of Korea, Seoul St. Mary’s Hospital, Seoul, Korea
4Department of Hospital Pathology, The Catholic University of Korea, Seoul St. Mary’s Hospital, Seoul, Korea
5Department of Surgery, The Catholic University of Korea, Seoul St. Mary’s Hospital, Seoul, Korea
Jae Myung Park, email: [email protected]
Keywords: positron emission tomography, gastric cancer, prognosis, tumor metabolism
Received: March 28, 2016 Accepted: August 10, 2016 Published: August 24, 2016
This study investigated the prognostic value of metabolic parameters determined by 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) in patients with stage III gastric cancer. Patients with pre-operative PET/CT and confirmed stage III after curative surgical resection were retrospectively enrolled. Parameters evaluated from pre-operative PET/CTwere maximum standardized uptake value (SUVmax) and peak SUV (SUVpeak) of primary tumor, SUVmax or SUVpeak of tumor to liver ratio (TLRmax and TLRpeak). Volumetric parameters, metabolic tumor volume (MTV) and total lesion glycolysis (TLG), were also evaluated. These PET/CT parameters were compared with the overall survival (OS) and recurrence-free survival (RFS). From total of 133 consecutive patients, tumor recurrence was found in 54 patients (40.6%) and 53 died during the follow-up period (median, 43 mo; range 5-62). In univariate analysis, SUVmax, SUVpeak, TLRmax and TLRpeak were significantly associated with the OS and RFS. In multivariate analysis, high TLRmax and TLRpeak were significantly unfavorable prognostic factors for RFS (both P<0.05) even after adjusting for age, depth of tumor invasion, lymph node metastasis, and chemotherapy. MTV and TLG showed no statistically significant correlation with outcome. In conclusion, glucose metabolism of primary tumor measured by pre-operative PET/CT provides prognostic information, especially for recurrence, in stage III gastric cancer.
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