Jeong Won Lee1, Jin Kyoung Oh2, Yong An Chung2, Sae Jung Na3, Seung Hyup Hyun4, Il Ki Hong5, Jae Seon Eo6, Bong-Il Song7, Tae-sung Kim8, Do Young Kim9, Seung Up Kim9, Dae Hyuk Moon10, Jong Doo Lee11, Mijin Yun12. 1. Department of Nuclear Medicine, International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon, Korea. 2. Department of Radiology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea. 3. Department of Radiology, Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea. 4. Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. 5. Department of Nuclear Medicine, Kyung Hee University Hospital, School of Medicine, Kyung Hee University, Seoul, Korea. 6. Department of Nuclear Medicine, Korea University Guro Hospital, Seoul, Korea. 7. Department of Nuclear Medicine, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea. 8. Department of Nuclear Medicine, National Cancer Center Research Institute and Hospital, Gyeonggi-do, Korea. 9. Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea. 10. Department of Nuclear Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea. 11. Department of Radiology, International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon, Korea; and yunmijin@yuhs.ac jdlee@ish.or.kr. 12. Department of Nuclear Medicine, Yonsei University College of Medicine, Seoul, Korea yunmijin@yuhs.ac jdlee@ish.or.kr.
Abstract
UNLABELLED: This study aimed to assess the prognostic value of (18)F-FDG uptake in hepatocellular carcinoma (HCC) patients who had transarterial chemoembolization (TACE) or concurrent intraarterial chemotherapy with external-beam radiotherapy (CCRT) and to compare the prognosis between patients treated with TACE and those with CCRT according to (18)F-FDG uptake. METHODS: Two hundred fourteen intermediate-to-advanced-stage HCC patients without extrahepatic metastasis who underwent staging (18)F-FDG PET/CT before TACE (153 patients) or CCRT (61 patients) were recruited from 7 hospitals. Progression-free survival (PFS) and overall survival (OS) were compared using an optimal cutoff value for tumor-to-normal liver uptake ratio (TLR). Further, PFS and OS were compared according to treatment modalities (TACE vs. CCRT) using the same TLR cutoff value. RESULTS: On multivariate analysis, age and TLR were independent prognostic factors for PFS (P< 0.050). For OS, Child-Pugh classification and TLR were independent prognostic factors (P< 0.050). When the TLR was greater than 2.0, patients treated with CCRT showed significantly better PFS and OS than those treated with TACE after adjusting for tumor size and number (P= 0.014, for all). In contrast, there was no significant difference in PFS and OS between patients treated with TACE or CCRT when the TLR was 2.0 or less. CONCLUSION: (18)F-FDG uptake was an independent prognostic factor for PFS and OS in HCC patients treated with TACE or CCRT. Especially, in HCCs with high (18)F-FDG uptake, patients treated with CCRT showed better survival than those treated with TACE. (18)F-FDG PET/CT may help determine the treatment modality for intermediate-to-advanced-stage HCCs.
UNLABELLED: This study aimed to assess the prognostic value of (18)F-FDG uptake in hepatocellular carcinoma (HCC) patients who had transarterial chemoembolization (TACE) or concurrent intraarterial chemotherapy with external-beam radiotherapy (CCRT) and to compare the prognosis between patients treated with TACE and those with CCRT according to (18)F-FDG uptake. METHODS: Two hundred fourteen intermediate-to-advanced-stage HCC patients without extrahepatic metastasis who underwent staging (18)F-FDG PET/CT before TACE (153 patients) or CCRT (61 patients) were recruited from 7 hospitals. Progression-free survival (PFS) and overall survival (OS) were compared using an optimal cutoff value for tumor-to-normal liver uptake ratio (TLR). Further, PFS and OS were compared according to treatment modalities (TACE vs. CCRT) using the same TLR cutoff value. RESULTS: On multivariate analysis, age and TLR were independent prognostic factors for PFS (P< 0.050). For OS, Child-Pugh classification and TLR were independent prognostic factors (P< 0.050). When the TLR was greater than 2.0, patients treated with CCRT showed significantly better PFS and OS than those treated with TACE after adjusting for tumor size and number (P= 0.014, for all). In contrast, there was no significant difference in PFS and OS between patients treated with TACE or CCRT when the TLR was 2.0 or less. CONCLUSION: (18)F-FDG uptake was an independent prognostic factor for PFS and OS in HCC patients treated with TACE or CCRT. Especially, in HCCs with high (18)F-FDG uptake, patients treated with CCRT showed better survival than those treated with TACE. (18)F-FDG PET/CT may help determine the treatment modality for intermediate-to-advanced-stage HCCs.
Authors: Yazan Abuodeh; Arash O Naghavi; Kamran A Ahmed; Puja S Venkat; Youngchul Kim; Bela Kis; Junsung Choi; Benjamin Biebel; Jennifer Sweeney; Daniel A Anaya; Richard Kim; Mokenge Malafa; Jessica M Frakes; Sarah E Hoffe; Ghassan El-Haddad Journal: World J Gastroenterol Date: 2016-12-21 Impact factor: 5.742
Authors: R Gallicchio; A Nardelli; P Mainenti; A Nappi; D Capacchione; V Simeon; C Sirignano; F Abbruzzi; F Barbato; M Landriscina; G Storto Journal: Biomed Res Int Date: 2016-08-03 Impact factor: 3.411