[논문]The clinical implications of FDG-PET/CT differ according to histology in advanced gastric cancer

Chon, Hong Jae; Kim, Chan; Cho, Arthur; Kim, Yoo Min; Jang, Su Jin; Kim, Bo Ok; Park, Chan Hyuk; Hyung, Woo Jin; Ahn, Joong Bae; Noh, Sung Hoon; Yun, Mijin; Rha, Sun Young

doi:10.1007/s10120-018-0847-5

The clinical implications of FDG-PET/CT differ according to histology in advanced gastric cancer 원문보기

Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association, v.22 no.1, 2019년, pp.113 - 122

Chon, Hong Jae (Medical Oncology, CHA Bundang Medical Center, CHA University, Seongnam, South Korea) , Kim, Chan (Medical Oncology, CHA Bundang Medical Center, CHA University, Seongnam, South Korea) , Cho, Arthur (Department of Nuclear Medicine, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-ku, Seoul, 120-752 South Korea) , Kim, Yoo Min (Department of Surgery, CHA Bundang Medical Center, CHA University, Seongnam, South Korea) , Jang, Su Jin (Department of Nuclear Medicine, CHA Bundang Medical Center, CHA University, Seongnam, South Korea) , Kim, Bo Ok (Biostatistics Collaboration Unit, Department of Research Affairs, Yonsei University College of Medicine, Seoul, South Korea) , Park, Chan Hyuk (Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, South Korea) , Hyung, Woo Jin (Department of Surgery, Yonsei University College of Medicine, Seoul, South Korea) , Ahn, Joong Bae (Department of Internal Medicine, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-ku, Seoul, 120-752 South Korea) , Noh, Sung Hoon (Department of Surgery, Yonsei University Col) , Yun, Mijin , Rha, Sun Young

Abstract ▼ AI-Helper

BackgroundThe prognostic impact of preoperative 18F-FDG PET/CT in advanced gastric cancer (AGC) remains a matter of debate. This study aims to evaluate the prognostic impact of SUVmax in preoperative 18F-FDG PET/CT of AGC according to histologic subtype, with a focus on the differences between tubular adenocarcinoma and signet ring cell (SRC) carcinoma.MethodsAs a discovery set, a total of 727 AGC patients from prospective database were analyzed according to histologic subtype with Cox proportional hazard model and p-spline curves. In addition, another 173 patients from an independent institution was assessed as an external validation set.ResultsIn multivariate analysis, high SUVmax in preoperative 18F-FDG PET/CT of AGC was negatively correlated with disease-free survival (DFS) and overall survival (OS) in patients with diffuse type (DFS: HR 2.17, P < 0.001; OS: HR 2.47, P < 0.001) or SRC histology (DFS: HR 2.26, P = 0.005; OS: HR 2.61, P = 0.003). This negative prognostic impact was not observed in patients with intestinal type or well or moderately differentiated histology. These findings have been consistently confirmed in a validation set. The p-spline curves also showed a gradual increase in log HR as SUVmax rises only for SRC histology and for diffuse-type AGC. Finally, a novel predictive model for recurrence of AGC with diffuse type or SRC histology was generated and validated based on the preoperative SUVmax.ConclusionsPreoperative high SUVmax of AGC is a poor prognostic factor in those with diffuse type or SRC histology. This study is the first to demonstrate the differential prognostic impact of preoperative PET/CT SUVmax in AGC according to histologic subtype and provide a clue to explain previous discrepancies in the prognostic impact of preoperative PET/CT in AGC. Prospective studies are required to validate the role of preoperative SUVmax in AGC.Electronic supplementary materialThe online version of this article (10.1007/s10120-018-0847-5) contains supplementary material, which is available to authorized users.

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The clinical implications of FDG-PET/CT differ according to histology in advanced gastric cancer 원문보기

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The clinical implications of FDG-PET/CT differ according to histology in advanced gastric cancer 원문보기

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