Preoperative Nodal ¹⁸F-FDG Avidity Rather than Primary Tumor Avidity Determines the Prognosis of Patients with Advanced Gastric Cancer
Journal of Gastric Cancer
; : 218-229, 2018.
Article
in En
| WPRIM
| ID: wpr-716712
Responsible library:
WPRO
ABSTRACT
PURPOSE: This study investigated whether the metabolic avidity of primary tumors and/or metastatic lymph nodes (LNs) measured by 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) was related to survival after surgery in patients with advanced gastric cancer (AGC). MATERIALS AND METHODS: One hundred sixty-eight patients with AGC who underwent preoperative 18F-FDG PET/CT and curative resection were included. The 18F-FDG avidity of the primary gastric tumor and LNs was determined quantitatively and qualitatively. The diagnostic performance of 18F-FDG PET/CT was calculated, and the prognostic significance of 18F-FDG avidity for recurrence-free survival (RFS) and overall survival (OS) was assessed. RESULTS: In all, 51 (30.4%) patients experienced recurrence, and 32 (19.0%) died during follow-up (median follow-up duration, 35 months; range, 3–81 months); 119 (70.8%) and 33 (19.6%) patients showed 18F-FDG-avid primary tumors and LNs, respectively. 18F-FDG PET/CT showed high sensitivity (73.8%) for the detection of advanced pathologic T (pT ≥3) stage and high specificity (92.2%) for the detection of advanced pN (≥2) stage. 18F-FDG avidity of LNs was significantly associated with RFS (P=0.012), whereas that of primary tumors did not show significance (P=0.532). Univariate and multivariate analyses revealed that 18F-FDG avidity of LNs was an independent prognostic factor for RFS (hazard ratio=2.068; P=0.029). CONCLUSIONS: 18F-FDG avidity of LNs is an independent prognostic factor for predicting RFS. Preoperative 18F-FDG PET/CT can be used to determine the risk and prognosis of patients with AGC after curative resection.
Key words
Full text:
1
Index:
WPRIM
Main subject:
Prognosis
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Recurrence
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Stomach Neoplasms
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Multivariate Analysis
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Follow-Up Studies
/
Sensitivity and Specificity
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Fluorodeoxyglucose F18
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Electrons
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Positron Emission Tomography Computed Tomography
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Lymph Nodes
Type of study:
Diagnostic_studies
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Observational_studies
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Prognostic_studies
/
Risk_factors_studies
Limits:
Humans
Language:
En
Journal:
Journal of Gastric Cancer
Year:
2018
Type:
Article