Ji Soo Park1, Nare Lee2, Seung Hoon Beom3, Hyo Song Kim3, Choong-Kun Lee3, Sun Young Rha3, Hyun Cheol Chung3, Mijin Yun4, Arthur Cho5, Minkyu Jung6. 1. Cancer Prevention Center, Yonsei Cancer Center, Seoul, Republic of Korea. 2. Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea. 3. Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea. 4. Department of Nuclear Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea. 5. Department of Nuclear Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea. artycho@yuhs.ac. 6. Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea. minkjung@yuhs.ac.
Abstract
BACKGROUND: We aimed to find the clinical value of metastatic tumor burden evaluated with F18-FDG PET/CT in gastric cancer patients, considering the human epidermal growth factor receptor 2 (HER2) status. METHODS: We retrospectively reviewed 124 patients with locally advanced or metastatic gastric cancer at Yonsei Cancer Center between January 2006 and December 2014 who had undergone baseline FDG PET/CT before first-line chemotherapy. We measured the maximum standardized uptake value from the primary tumor (SUVmax) and whole-body (WB) PET/CT parameters, including WB SUVmax, WB SUVmean, WB metabolic tumor volume (WB MTV), and WB total lesion glycolysis (WB TLG), in all metabolically active metastatic lesions (SUV threshold ≥2.5 or 40% isocontour for ≤2.5), and we determined their association with patient survival outcomes. RESULTS: SUVmax was higher in HER2-positive gastric cancers (median 12.1, range 3.4-34.6) compared to HER-2 negative (7.4, 1.6-39.1, P < 0.001). Among all patients, WB TLG > 600, which is indicative of a high metastatic tumor burden, showed worse progression-free survival (PFS) [hazard ratio (HR), 2.003; 95% CI, 1.300-3.086; P = 0.002] and overall survival (OS) (HR, 3.001; 95% CI, 1.950-4.618; P < 0.001) than did WB TLG ≤ 600. Among HER2-positive gastric cancer patients treated with trastuzumab, higher metabolic tumor burden predicted worse OS, but not PFS. CONCLUSIONS: HER2-positive gastric cancers had higher SUVmax compared to HER2-negative gastric cancers. In both HER2-negative patients and -positive patients receiving trastuzumab, FDG PET/CT volume-based parameters may have a role in further stratifying the prognosis of stage IV gastric cancer.
BACKGROUND: We aimed to find the clinical value of metastatic tumor burden evaluated with F18-FDG PET/CT in gastric cancerpatients, considering the humanepidermal growth factor receptor 2 (HER2) status. METHODS: We retrospectively reviewed 124 patients with locally advanced or metastatic gastric cancer at Yonsei Cancer Center between January 2006 and December 2014 who had undergone baseline FDG PET/CT before first-line chemotherapy. We measured the maximum standardized uptake value from the primary tumor (SUVmax) and whole-body (WB) PET/CT parameters, including WB SUVmax, WB SUVmean, WB metabolic tumor volume (WB MTV), and WB total lesion glycolysis (WB TLG), in all metabolically active metastatic lesions (SUV threshold ≥2.5 or 40% isocontour for ≤2.5), and we determined their association with patient survival outcomes. RESULTS: SUVmax was higher in HER2-positive gastric cancers (median 12.1, range 3.4-34.6) compared to HER-2 negative (7.4, 1.6-39.1, P < 0.001). Among all patients, WB TLG > 600, which is indicative of a high metastatic tumor burden, showed worse progression-free survival (PFS) [hazard ratio (HR), 2.003; 95% CI, 1.300-3.086; P = 0.002] and overall survival (OS) (HR, 3.001; 95% CI, 1.950-4.618; P < 0.001) than did WB TLG ≤ 600. Among HER2-positive gastric cancerpatients treated with trastuzumab, higher metabolic tumor burden predicted worse OS, but not PFS. CONCLUSIONS:HER2-positive gastric cancers had higher SUVmax compared to HER2-negative gastric cancers. In both HER2-negative patients and -positive patients receiving trastuzumab, FDG PET/CT volume-based parameters may have a role in further stratifying the prognosis of stage IV gastric cancer.
Authors: Virginie Frings; Adrianus J de Langen; Egbert F Smit; Floris H P van Velden; Otto S Hoekstra; Harm van Tinteren; Ronald Boellaard Journal: J Nucl Med Date: 2010-11-15 Impact factor: 10.057
Authors: Kinga Grabinska; Maciej Pelak; Jerzy Wydmanski; Andrzej Tukiendorf; Andrea d'Amico Journal: World J Gastroenterol Date: 2015-05-21 Impact factor: 5.742
Authors: M Hofmann; O Stoss; D Shi; R Büttner; M van de Vijver; W Kim; A Ochiai; J Rüschoff; T Henkel Journal: Histopathology Date: 2008-04-18 Impact factor: 5.087
Authors: Alexander Stahl; Katja Ott; Wolfgang Andreas Weber; Karen Becker; Thomas Link; Jörg-Rüdiger Siewert; Markus Schwaiger; Ulrich Fink Journal: Eur J Nucl Med Mol Imaging Date: 2002-11-08 Impact factor: 9.236
Authors: Kazuto Harada; Madhavi Patnana; Xuemei Wang; Masaaki Iwatsuki; Mariela A Blum Murphy; Meina Zhao; Prajnan Das; Bruce D Minsky; Brian Weston; Jeffrey H Lee; Manoop S Bhutani; Jeannelyn S Estrella; Namita Shanbhag; Naruhiko Ikoma; Brian D Badgwell; Jaffer A Ajani Journal: Surg Today Date: 2020-05-14 Impact factor: 2.540