Chae Hong Lim1, Seung Hwan Moon1, Young Seok Cho1, Joon Young Choi1, Kyung-Han Lee1, Seung Hyup Hyun2. 1. Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81, Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea. 2. Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81, Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea. shnm.hyun@samsung.com.
Abstract
PURPOSE: The prognostic value of pretreatment 18F-fluorodeoxyglucose positron emission tomography with computed tomography (FDG PET/CT) was assessed in patients with combined hepatocellular-cholangiocarcinoma (cHCC-CC). METHODS: A total of 46 patients with cHCC-CC who underwent FDG PET/CT before treatment were retrospectively analysed. Tumour FDG avidity was measured in terms of the tumour-to-normal liver standardized uptake value ratio (TLR) of the primary tumour on FDG PET/CT. The prognostic significance of TLR using the median value of 3.4 as the cut-off value and other clinical variables was assessed using Cox proportional hazards regression models. Differences in progression-free survival (PFS) and overall survival (OS) in relation to TLR were examined by the Kaplan-Meier method. RESULTS: During a median follow-up period of 29 months, 29 patients (63.0%) showed tumour recurrence or progression, and 25 patients (54.4%) died from cancer. Higher TLRs (>3.4) were associated with larger tumour size (p = 0.007) and higher tumour stage (p = 0.030). In a univariable analysis, TLR, tumour stage and CEA were significant prognostic predictors. In a multivariable analysis, TLR was an independent predictor of PFS (HR 5.19, 95% CI 1.80-15.01; p = 0.002) and OS (HR 3.95, 95% CI 1.27-12.24; p = 0.017). Patients with a higher TLR showed significantly worse PFS (2-year survival rate 17.8% vs. 62.9%; p = 0.001) and OS (2-year survival rate, 39.1% vs. 77.3%; p = 0.001) than those with a lower TLR. CONCLUSION: Pretreatment TLR of the primary tumour measured on FDG PET/CT is an independent predictor of survival in patients with cHCC-CC.
PURPOSE: The prognostic value of pretreatment 18F-fluorodeoxyglucose positron emission tomography with computed tomography (FDG PET/CT) was assessed in patients with combined hepatocellular-cholangiocarcinoma (cHCC-CC). METHODS: A total of 46 patients with cHCC-CC who underwent FDG PET/CT before treatment were retrospectively analysed. TumourFDG avidity was measured in terms of the tumour-to-normal liver standardized uptake value ratio (TLR) of the primary tumour on FDG PET/CT. The prognostic significance of TLR using the median value of 3.4 as the cut-off value and other clinical variables was assessed using Cox proportional hazards regression models. Differences in progression-free survival (PFS) and overall survival (OS) in relation to TLR were examined by the Kaplan-Meier method. RESULTS: During a median follow-up period of 29 months, 29 patients (63.0%) showed tumour recurrence or progression, and 25 patients (54.4%) died from cancer. Higher TLRs (>3.4) were associated with larger tumour size (p = 0.007) and higher tumour stage (p = 0.030). In a univariable analysis, TLR, tumour stage and CEA were significant prognostic predictors. In a multivariable analysis, TLR was an independent predictor of PFS (HR 5.19, 95% CI 1.80-15.01; p = 0.002) and OS (HR 3.95, 95% CI 1.27-12.24; p = 0.017). Patients with a higher TLR showed significantly worse PFS (2-year survival rate 17.8% vs. 62.9%; p = 0.001) and OS (2-year survival rate, 39.1% vs. 77.3%; p = 0.001) than those with a lower TLR. CONCLUSION: Pretreatment TLR of the primary tumour measured on FDG PET/CT is an independent predictor of survival in patients with cHCC-CC.
Entities:
Keywords:
Combined hepatocellular-cholangiocarcinoma; FDG PET/CT; Prognosis; Standardized uptake value
Authors: Jong Doo Lee; Woo Ick Yang; Young Nyun Park; Kyung Sik Kim; Jin Sub Choi; Mijin Yun; Dooheun Ko; Tae-Sung Kim; Arthur E H Cho; Hye Mi Kim; Kwang-Hyub Han; Seung-Soon Im; Yong-Ho Ahn; Chang Woon Choi; Jeon Han Park Journal: J Nucl Med Date: 2005-10 Impact factor: 10.057
Authors: Jong Doo Lee; Mijin Yun; Jae Myun Lee; Youjeong Choi; Youn-Hee Choi; Ji Su Kim; Se Jong Kim; Kyung Sik Kim; Woo Ick Yang; Young Nyun Park; Kwang-Hyub Han; Woo Jung Lee; Naechun Yoo; Sang Moo Lim; Jeon Han Park Journal: Eur J Nucl Med Mol Imaging Date: 2004-07-28 Impact factor: 9.236