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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 em En | WPRIM | ID: wpr-716712
Biblioteca responsável: 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.
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Texto completo: 1 Índice: WPRIM Assunto principal: Prognóstico / Recidiva / Neoplasias Gástricas / Análise Multivariada / Seguimentos / Sensibilidade e Especificidade / Fluordesoxiglucose F18 / Elétrons / Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada / Linfonodos Tipo de estudo: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Humans Idioma: En Revista: Journal of Gastric Cancer Ano de publicação: 2018 Tipo de documento: Article
Texto completo: 1 Índice: WPRIM Assunto principal: Prognóstico / Recidiva / Neoplasias Gástricas / Análise Multivariada / Seguimentos / Sensibilidade e Especificidade / Fluordesoxiglucose F18 / Elétrons / Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada / Linfonodos Tipo de estudo: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Humans Idioma: En Revista: Journal of Gastric Cancer Ano de publicação: 2018 Tipo de documento: Article