BACKGROUND: The prognostic and predictive abilities of 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) coupled with conventional computed tomography (CT) have not been studied in patients with unresectable colorectal liver metastases (uCRLM) treated with combined hepatic arterial infusion (HAI) and systemic chemotherapy. OBJECTIVES: The ability of PET-CT metabolic response parameters to predict conversion to resectability and oncologic outcome in this setting was evaluated. METHODS: Thirty-eight patients undergoing serial PET-CT as part of a Phase II trial of HAI and systemic chemotherapy for uCRLM were included. Metabolic response was determined as the percentage change in standard uptake value (SUV) and total lesion glycolysis (TLG). Conversion to resection, overall survival (OS), progression-free survival (PFS) and recurrence-free survival were evaluated using standard statistics. RESULTS: Volumetric response sufficient to facilitate resection was seen in 53% of patients after a median of 5 months of therapy. Median follow-up was 38 months (range: 32-52 months). Median OS was not reached [95% confidence interval (CI) 32 months-unknown] and 3-year OS was 54% (range: 33-71%). Median PFS was 13 months (95% CI 6-21 months) and 3 year PFS was 10% (range: 3-20%). Neither baseline values nor the percentage change in any of the metabolic parameters evaluated correlated with conversion to resection, survival variables or hepatic recurrence on Cox regression analysis. CONCLUSIONS: Pre- and post-treatment PET-related metabolic parameters do not predict conversion to resection or oncologic outcome in patients with uCRLM treated with HAI and systemic chemotherapy. Metabolic parameters should not be used to monitor response or to determine prognosis in these patients.
BACKGROUND: The prognostic and predictive abilities of 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) coupled with conventional computed tomography (CT) have not been studied in patients with unresectable colorectal liver metastases (uCRLM) treated with combined hepatic arterial infusion (HAI) and systemic chemotherapy. OBJECTIVES: The ability of PET-CT metabolic response parameters to predict conversion to resectability and oncologic outcome in this setting was evaluated. METHODS: Thirty-eight patients undergoing serial PET-CT as part of a Phase II trial of HAI and systemic chemotherapy for uCRLM were included. Metabolic response was determined as the percentage change in standard uptake value (SUV) and total lesion glycolysis (TLG). Conversion to resection, overall survival (OS), progression-free survival (PFS) and recurrence-free survival were evaluated using standard statistics. RESULTS: Volumetric response sufficient to facilitate resection was seen in 53% of patients after a median of 5 months of therapy. Median follow-up was 38 months (range: 32-52 months). Median OS was not reached [95% confidence interval (CI) 32 months-unknown] and 3-year OS was 54% (range: 33-71%). Median PFS was 13 months (95% CI 6-21 months) and 3 year PFS was 10% (range: 3-20%). Neither baseline values nor the percentage change in any of the metabolic parameters evaluated correlated with conversion to resection, survival variables or hepatic recurrence on Cox regression analysis. CONCLUSIONS: Pre- and post-treatment PET-related metabolic parameters do not predict conversion to resection or oncologic outcome in patients with uCRLM treated with HAI and systemic chemotherapy. Metabolic parameters should not be used to monitor response or to determine prognosis in these patients.
Authors: Nancy E Kemeny; William R Jarnagin; Marinela Capanu; Yuman Fong; Alexandra N Gewirtz; Ronald P Dematteo; Michael I D'Angelica Journal: J Clin Oncol Date: 2010-12-28 Impact factor: 44.544
Authors: Jeannine A Ruby; Tobias Leibold; Timothy J Akhurst; Jinru Shia; Leonard B Saltz; Madhu Mazumdar; Elyn R Riedel; Steven M Larson; José G Guillem Journal: Dis Colon Rectum Date: 2012-04 Impact factor: 4.585
Authors: T J M Ruers; B S Langenhoff; N Neeleman; G J Jager; S Strijk; Th Wobbes; F H M Corstens; W J G Oyen Journal: J Clin Oncol Date: 2002-01-15 Impact factor: 44.544
Authors: Steven M. Larson; Yusuf Erdi; Timothy Akhurst; Madhu Mazumdar; Homer A. Macapinlac; Ronald D. Finn; Cecille Casilla; Melissa Fazzari; Neil Srivastava; Henry W.D. Yeung; John L. Humm; Jose Guillem; Robert Downey; Martin Karpeh; Alfred E. Cohen; Robert Ginsberg Journal: Clin Positron Imaging Date: 1999-05
Authors: Nancy E Kemeny; Fidel D Huitzil Melendez; Marinela Capanu; Philip B Paty; Yuman Fong; Lawrence H Schwartz; William R Jarnagin; Dina Patel; Michael D'Angelica Journal: J Clin Oncol Date: 2009-05-26 Impact factor: 44.544
Authors: Okker D Bijlstra; Maud M E Boreel; Sietse van Mossel; Mark C Burgmans; Ellen H W Kapiteijn; Daniela E Oprea-Lager; Daphne D D Rietbergen; Floris H P van Velden; Alexander L Vahrmeijer; Rutger-Jan Swijnenburg; J Sven D Mieog; Lioe-Fee de Geus-Oei Journal: Diagnostics (Basel) Date: 2022-03-15