Prognostic Significance of Pre-operative FDG-PET in Colorectal Cancer Patients with Hepatic Metastasis.
- Author:
Hyo Sang LEE
1
;
Won Woo LEE
;
Duck Woo KIM
;
Sung Bum KANG
;
Kyoung Ho LEE
;
Keun Wook LEE
;
Jee Hyun KIM
;
Sang Eun KIM
Author Information
1. Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Korea. wwlee@snu.ac.kr
- Publication Type:Original Article
- Keywords:
Colorectal cancer;
hepatic metastasis;
prognosis;
fluorodeoxyglucose;
positron emission tomography
- MeSH:
Colorectal Neoplasms;
Disease-Free Survival;
Follow-Up Studies;
Humans;
Lymph Nodes;
Multivariate Analysis;
Neoplasm Metastasis;
Positron-Emission Tomography;
Prognosis;
Recurrence
- From:Nuclear Medicine and Molecular Imaging
2009;43(5):429-435
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: The purpose of this study was to assess the prognostic value of preoperative FDG-PET in colorectal cancer (CRC) patients with hepatic metastasis (HM). MATERIALS AND METHODS: 24 CRC patients (M:F=14:10; age, 63+/-10 yrs) with HM who had undergone preoperative FDG PET were included. Cure-intent surgery was performed in all the patients and HMs were controlled using resection (n=13), radio-frequency ablation (RFA) (n=7), and resection plus RFA (n=4). Potential prognostic markers tested were maxSUV of primary tumor, maxSUV of HM, maxSUV ratio of HM over primary tumor (M/P ratio), histologic grade, CEA level, venous/lymphatic/nerve invasion, T stage, N stage, no. of HM, no. of lymph node metastasis, and treatment modality of HM. RESULTS: 14 CRC patients developed a recurrence with a median follow-up duration of 244 days, whereas 10 patients did not develop recurrence with a median follow-up duration of 504 days. M/P ratios but other potential prognostic markers were significantly higher in the recurrent patients (0.72+/-0.14) than recurrence-free patients (0.54+/-0.23) (p=0.038). M/P ratio only was found to predict recurrence by Cox multivariate analysis (hazard ratio 37.7, 95% confidence interval 2.01-706.1, p=0.016). The 11 patients with lower M/P ratio of <0.61 had significantly better disease-free survival rate than the 13 patients with higher M/P ratio (> or =0.61) (p=0.026). CONCLUSION: maxSUV ratio of HM over primary tumor (M/P ratio) may be useful for prognosis prediction of CRC patients with HM. Higher FDG uptake of HM than that of primary tumor may indicate a more advanced status in stage IV CRC.
