Prognostic Value of FDG-PET/CT Parameters in Patients with Locally Advanced Rectal Cancer Treated with Neoadjuvant Approach
Makaleler > Tam Makale · 2020
Yazarlar: Fatma YAVAŞ, Aylin ORAL, Recep SAVAŞ, Deniz YALMAN, Serdar ÖZKÖK
Turkish Journal of Oncology, ESCI İndekslerine Giren Dergi, Uluslararası, Scopus, 2020, cilt 35, ss 134-143
Özet
To determine the prognostic and/or predictive role of 18F-FDG PET/CT parameters, such as SUVmax, SUVmean, Metabolic Tumor Volume (MTV) and Total Lesion Glycolysis (TLG=MTVxSUVmean), for the patients with locally advanced rectal cancer (LARC) treated with neoadjuvant radiotherapy±chemotherapy. METHODSBetween January 2005 and December 2016, a total of 106 patients with clinical T3-4 and/or N+ rectal cancer without distant metastasis were included in this study.Correlation between metabolic and volumetric parameters and tumor characteristics was evaluated.Prognostic factors for overall survival (OS), local recurrence-free survival (LRFS), and distant metastasis-free survival (DMFS) were analyzed. RESULTSThe median follow-up duration for all patients was 39.0 months (range, 6-103 months).Pathologic complete response (pCR) was defined as the absence of viable cancer cells in the resected specimen (ypT0N0).pCR was achieved in 17% of all cases (18/106).There was a weak correlation between SUVmax of primary tumor and MTV ([r]=0.238;p<0.001).However, SUVmax of primary tumor and TLG were significantly correlated (r=0.538;p<0.001).Neither SUVmax nor SUVmean was affected by patient and tumor characteristics.Posttreatment extensive stage of disease (p=0.013),absence of concomitant CT (p=0.012),MTV ≥14.65 cm 3 (p=0.008),and TLG ≥117.00 (p=0.023) were unfavorable prognostic factors for OS on multivariate analysis. CONCLUSIONAlthough FDG-PET is not a standard imaging modality for the treatment of rectal cancers, a negative effect of high MTV and TLG on OS was shown in our study.We should consider more intense treatment approaches for tumors with high MTV and TLG values.