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

被引：18

作者：

Chon, Hong Jae ^{[1
,2
]}

Kim, Chan ^{[1
]}

Cho, Arthur ^{[3
]}

Kim, Yoo Min ^{[4
]}

Jang, Su Jin ^{[5
]}

Kim, Bo Ok ^{[6
]}

Park, Chan Hyuk ^{[7
]}

Hyung, Woo Jin ^{[8
]}

Ahn, Joong Bae ^{[9
]}

Noh, Sung Hoon ^{[8
]}

Yun, Mijin ^{[3
]}

Rha, Sun Young ^{[9
]}

机构：

[1] CHA Univ, CHA Bundang Med Ctr, Med Oncol, Seongnam, South Korea

[2] Yonsei Univ, Coll Med, Yonsei Grad Sch, Seoul, South Korea

[3] Yonsei Univ, Coll Med, Dept Nucl Med, 50 Yonsei Ro, Seoul 120752, South Korea

[4] CHA Univ, Dept Surg, CHA Bundang Med Ctr, Seongnam, South Korea

[5] CHA Univ, Dept Nucl Med, CHA Bundang Med Ctr, Seongnam, South Korea

[6] Yonsei Univ, Dept Res Affairs, Biostat Collaborat Unit, Coll Med, Seoul, South Korea

[7] Hanyang Univ, Guri Hosp, Dept Internal Med, Coll Med, Guri, South Korea

[8] Yonsei Univ, Dept Surg, Coll Med, Seoul, South Korea

[9] Yonsei Univ, Coll Med, Dept Internal Med, 50 Yonsei Ro, Seoul 120752, South Korea

来源：

GASTRIC CANCER | 2019年 / 22卷 / 01期

基金：

新加坡国家研究基金会;

关键词：

Advanced gastric cancer; PET; CT; Prognostic impact; Signet ring cell carcinoma; Diffuse type; SURGICAL RESECTION; METABOLISM; CARCINOMA;

D O I：

10.1007/s10120-018-0847-5

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

BackgroundThe prognostic impact of preoperative F-18-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 F-18-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 F-18-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.

引用

页码：113 / 122

页数：10