scholarly journals Preoperative PET/CT 18F-FDG Standardized Uptake by Lymph Nodes as a Significant Prognostic Factor in Patients with Colorectal Cancer

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Ruohua Chen ◽  
Yining Wang ◽  
Xiang Zhou ◽  
Gang Huang ◽  
Jianjun Liu

Purpose. We evaluated the prognostic value of preoperative 18F-FDG uptake by suspected lymph nodes (LNs) using 18F-FDG PET/CT in colorectal cancer patients. Methods. Patients with CRC underwent 18F-FDG PET/CT before radical surgery. We used Cox proportional hazards regression to examine the relationship between recurrence and the 18F-FDG maximum standardized uptake value (SUVmax) in the suspected LNs (SUVLN) on 18F-FDG PET/CT. Results. Clinical data, treatment modalities, and results from 90 CR C patients were reviewed. The median follow-up was 19 months (range 3 to 72 months). Receiver operating characteristic analysis identified SUVLN 1.15 was the optimal cut-off value for predicting recurrence. SUVLN correlated with tumour size (P=0.045), lymph node metastasis (P=0.03), and recurrence (P<0.0001). Univariate analysis showed significant associations between recurrence and SUVLN (P=0.017), and tumour grade (P=0.013). Multivariate analysis identified SUVLN (P<0.0001), and tumour grade (P=0.005) as independent risk factors for recurrence. Patients with SUVLN ≤ 1.15 and SUVLN > 0.15 differed significantly in terms of recurrence (P<0.0001). Conclusion. Preoperative SUVLN measured by 18F-FDG PET/CT was significantly associated with recurrence and had significant prognostic value for recurrence-free survival in patients with colorectal cancer.

2020 ◽  
Author(s):  
Romain Mallet ◽  
Romain Modzelewski ◽  
Justine Lequesne ◽  
Sorina Dana Mihailescu ◽  
Pierre Decazes ◽  
...  

Abstract Background: Sarcopenia is defined by a loss of skeletal muscle mass with or without loss of fat mass. Sarcopenia has been associated to reduced tolerance to treatment and worse prognosis in cancer patients, including patients undergoing surgery for limited oesophageal cancer. Concomitant chemo-radiotherapy is the standard treatment for locally-advanced tumour, not accessible to surgical resection. Using automated delineation of the skeletal muscle, we have investigated the prognostic value of sarcopenia in locally advanced oesophageal cancer (LAOC) patients treated by curative-intent chemo-radiotherapy.Methods: The clinical, nutritional, anthropometric, and functional-imaging (18FDG-PET/CT) data were collected in 97 patients treated between 2006 and 2012 in our institution. The skeletal muscle area was automatically delineated on cross-sectional CT images acquired at the 3rd. lumbar vertebra level and divided by the patient’s squared height (SML3/h²) to obtain the Skeletal Muscle Index (SMI). The primary endpoint was overall survival probability.Results: Seventy-six deaths were reported. The median survival time was 27 [95% Confidence Interval 23 – 40] months for the whole population. Univariate analyses (Cox Proportional Hazard Model) showed decreased survival probabilities in patients with reduced SMI, WHO >0, Body Mass Index ≤21, and Nutritional Risk Index ≤97.5. Multivariate analyses showed that sarcopenia was the only significant prognostic factor (HR 2.32 [1.24-4.34], p=0.008). Using Receiver Operating Characteristics curves, the Area Under the Curve (AUC) was 0.73 in males (p=0.0002], the optimal threshold being 51.5 cm²/m². In women, the AUC was 0.65 (p=0.19).Conclusion: Sarcopenia is a powerful independent prognostic factor, associated with a rise of the overall mortality in patients treated exclusively by radiochemotherapy for a locally advanced oesophageal cancer. L3 CT images are easily gathered from 18FDG-PET/CT acquisitions


2020 ◽  
Vol 49 (1) ◽  
pp. 1
Author(s):  
Emir Sokolović ◽  
Timur Cerić ◽  
Šejla Cerić ◽  
Semir Bešlija ◽  
Sandra Vegar-Zubović ◽  
...  

<p><strong>Objective. </strong>The aim of the study was to evaluate the prognostic value of the maximum standardized uptake value (SUVmax) of 18F-Fluorodeoxyglucose (18F-FDG) PET/CT in patients with metastatic colorectal cancer, and to compare it with classical prognostic markers.</p><p><strong>Materials and Methods. </strong>The study included 70 patients with metastatic colorectal cancer who had not been treated for the metastatic disease. The patients underwent 18F-FDG PET/CT as part of their routine diagnostic reevaluation. During the analysis, the value of the largest tumor diameter and SUVmax was determined for the lesion with the highest SUVmax observed. The values of CEA and CA 19-9 were recorded 7 days before the PET/CT analysis.</p><p><strong>Results. </strong>SUVmax and Carbohydrate antigen (CA)19-9 were found to be independent prognostic markers of disease progression within 12 months. Based on the Receiver Operating Characteristics (ROC) curve analysis, the patients could be divided into two groups: SUVmax≤4.1 vs. SUVmax&gt;4.1. Patients with SUVmax values of 4.1 or less had significantly better progression-free survival within 12 months with an HR (95% CI) of 2.97 (1.4-6.3), relative to patients with SUVmax values above 4.1.</p><p><strong>Conclusion. </strong>SUVmax may be used as a novel prognostic marker of disease progression among patients with metastatic colorectal cancer. Values of SUVmax can be used to select patients with a more aggressive type of disease and higher risk for progression within 12 months of PET/CT analysis.</p>


2020 ◽  
Author(s):  
Romain Mallet ◽  
Romain Modzelewski ◽  
Justine Lequesne ◽  
Sorina Dana Mihailescu New ◽  
Pierre Decazes ◽  
...  

Abstract Background: Sarcopenia is defined by a loss of skeletal muscle mass with or without loss of fat mass. Sarcopenia has been associated to reduced tolerance to treatment and worse prognosis in cancer patients, including patients undergoing surgery for limited oesophageal cancer. Concomitant chemo-radiotherapy is the standard treatment for locally-advanced tumour, not accessible to surgical resection. Using automated delineation of the skeletal muscle, we have investigated the prognostic value of sarcopenia in locally advanced oesophageal cancer (LAOC) patients treated by curative-intent chemo-radiotherapy.Methods: The clinical, nutritional, anthropometric, and functional-imaging (18FDG-PET/CT) data were collected in 97 patients treated between 2006 and 2012 in our institution. The skeletal muscle area was automatically delineated on cross-sectional CT images acquired at the 3rd. lumbar vertebra level and divided by the patient’s squared height (SML3/h²) to obtain the Skeletal Muscle Index (SMI). The primary endpoint was overall survival probability.Results: Seventy-six deaths were reported. The median survival time was 27 [95% Confidence Interval 23 – 40] months for the whole population. Univariate analyses (Cox Proportional Hazard Model) showed decreased survival probabilities in patients with reduced SMI, WHO >0, Body Mass Index ≤21, and Nutritional Risk Index ≤97.5. Multivariate analyses showed that sarcopenia was the only significant prognostic factor (HR 2.32 [1.24-4.34], p=0.008). Using Receiver Operating Characteristics curves, the Area Under the Curve (AUC) was 0.73 in males (p=0.0002], the optimal threshold being 51.5 cm²/m². In women, the AUC was 0.65 (p=0.19).Conclusion: Sarcopenia is a powerful independent prognostic factor, associated with a rise of the overall mortality in patients treated exclusively by radiochemotherapy for a locally advanced oesophageal cancer. L3 CT images are easily gathered from 18FDG-PET/CT acquisitions


2020 ◽  
Vol 11 (10) ◽  
pp. 2864-2873 ◽  
Author(s):  
Hao Jiang ◽  
Rongjun Zhang ◽  
Huijie Jiang ◽  
Mingyu Zhang ◽  
Wei Guo ◽  
...  

2020 ◽  
Vol 9 (9) ◽  
pp. 2715
Author(s):  
Reyhaneh Manafi-Farid ◽  
Alexander Kupferthaler ◽  
Helwig Wundsam ◽  
Georg Gruber ◽  
Reza Vali ◽  
...  

Accurate staging and treatment planning are imperative for precise management in Anal Cancer (ACa) patients. We aimed to evaluate the additive and prognostic value of pre-treatment 2-[18F]fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography (2-[18F]FDG PET/CT) in the staging and management of ACa compared to magnetic resonance imaging (MRI). This retrospective study was conducted on 54 patients. Pre-treatment 2-[18F]FDG PET/CT studies and MRI reports were compared considering the primary tumor, pelvic lymph nodes, and metastatic lesions. The impact of 2-[18F]FDG PET/CT in the management and its prognostic value, using maximum standardized uptake value (SUVmax), were assessed. Discordant findings were found in 46.3% of patients (5 in T; 1 in T and N; 18 in N; and 1 in M stage). 2-[18F]FDG PET/CT resulted in up-staging in 9.26% and down-staging in 3.7% of patients. Perirectal lymph nodes were metabolically inactive in 12.9% of patients. Moreover, 2-[18F]FDG PET/CT resulted in management change in 24.1% of patients. Finally, SUVmax provided no prognostic value. 2-[18F]FDG PET/CT altered staging and management in a sizable number of patients in this study, and supports a need for a change in guidelines for it to be used as a routine complementary test in the initial management of ACa.


2020 ◽  
Author(s):  
Francisco Tustumi ◽  
Flávio Roberto Takeda ◽  
Paulo Schiavom Duarte ◽  
David Gutiérrez Albenda ◽  
Rubens Antonio Aissar Sallum ◽  
...  

Abstract Objective:Quantitative 18F-FDG PET/CT parameters have been described as prognostic indicators in esophageal cancer. The objective of this study isto evaluate the prognostic value of the maximum standardized uptake value (SUVmax), metabolic tumor value (MTV) and total lesion glycolysis (TLG) measured in the primary tumor and suspicious lymph nodes.Methods: A cohort study was performed to assess the association of SUVmax, MTV and TLG measured prior to and post neoadjuvant therapywithoverall survival (OS) of patients with esophageal cancer who received trimodal therapy. The quantitative techniques were applied in the primary tumor and suspicious lymph nodes. The OS rates were analyzed. Results: Before neoadjuvant therapy, 106 patients underwent PET/CT, and 39 patients underwent post-neoadjuvant therapy PET/CT exams. Before neoadjuvanttherapy, PET/CT showed that all the variables of the evaluated lymph nodes were statistically significant in predicting OS. Postneoadjuvanttherapy, none of the PET/CT variables of lymph nodes were related to prognosis. On the other hand, all primary tumor volumetric variables were related to overall survival. The MTV (HR: 4.66; 95% CI: 1.54-14.08) and TLG (HR: 4.86; 95% CI: 1.66-14.26) of the primary tumor post neoadjuvanttherapy and the variations in MTV (HR: 2.95; 95% CI: 1.01-3.52) and TLG (HR: 3.49; 95% CI: 1.01-3.52) of the primary tumor pre-to-post-neoadjuvanttherapy were prognostic variables. Conclusion: In patients with esophageal cancer, the burden of disease in suspicious lymph nodes and the primary tumor prior to therapy and the residual burden of disease in the primary tumor post therapy assessed by PET/CT were associated with prognosis.


Cancers ◽  
2020 ◽  
Vol 12 (10) ◽  
pp. 2752
Author(s):  
Silvia Camera ◽  
Tugba Akin Telli ◽  
Erwin Woff ◽  
Caroline Vandeputte ◽  
Pashalina Kehagias ◽  
...  

Introduction: Decision making in refractory colorectal cancer (rCRC) is challenging, with limited data available to predict patient outcome. We conducted a study to assess the pace of cancer progression as a potential prognostic and decision tool. Methods: CORIOLAN was a prospective, single-center, single-arm trial recruiting refractory CRC patients with an ECOG performance status of ≤1 and an estimated life expectancy of ≥12 weeks. 18 fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) scan and blood sample collection were carried out at baseline and after 2 weeks with no cancer treatment given between these timepoints. The primary objective was to evaluate the association between pace of cancer progression as defined by changes of the whole-body metabolically active tumor volume (WB-MATV) and overall survival (OS). Exploratory objectives included evaluation of the prognostic value of circulating cell-free DNA (cfDNA), circulating tumor cells (CTCs) and carcinoembryonic antigen (CEA). Results: 47 eligible patients who had received a median number of 5 (range 2–8) prior treatments were enrolled. At the time of analysis, 45 deaths had occurred, with 26% of patients dying within 12 weeks. The median OS was 6.3 months (range 0.4–14.3). The median relative delta between WB-MATV at baseline and 2 weeks was +21%. Changes of WB-MATV, however, failed to predict OS (hazard ratio (HR) 1.3, p = 0.383). Similarly, no association was observed between changes of any of the circulating biomarkers investigated and prognosis. By contrast, high WB-MATV (4.2 versus 9.4 months; HR 3.1, p = 0.003), high CEA (4.4 versus 7.0 months; HR 1.9, p = 0.053), high cfDNA (4.7 versus 7.0 months; HR 2.2, p = 0.015) and high CTC count (3.3 versus 7.5 months; HR 6.5, p < 0.001) at baseline were associated with worse OS. Conclusions: In this study, approximately 1 out of 4 refractory CRC patients who were judged to have a life expectancy >12 weeks actually died within 12 weeks. Baseline assessment of WB-MATV, cfDNA, CTCs and CEA, but not early change evaluation of the same, may help to refine patient prognostication and guide management decisions.


2020 ◽  
Author(s):  
Francisco Tustumi ◽  
Flávio Roberto Takeda ◽  
Paulo Schiavom Duarte ◽  
David Gutiérrez Albenda ◽  
Rubens Antonio Aissar Sallum ◽  
...  

Abstract Background: Quantitative 18F-FDG PET/CT parameters have been described as prognostic indicators in esophageal cancer. The aim of this study was to evaluate the prognostic value of the maximum standardized uptake value (SUVmax), metabolic tumor value (MTV) and total lesion glycolysis (TLG) measured in the primary tumor and suspicious lymph nodes. A cohort study was performed to assess the association of SUVmax, MTV and TLG measured prior to and post neoadjuvant therapy with overall survival (OS) of patients with esophageal cancer who received trimodal therapy. The quantitative techniques were applied in the primary tumor and suspicious lymph nodes. The OS rates were analyzed. Results: Before neoadjuvant therapy, 106 patients underwent PET/CT, and 39 patients underwent post-neoadjuvant therapy PET/CT exams. Before neoadjuvant therapy, PET/CT showed that all the variables of the evaluated lymph nodes were statistically significant in predicting OS. Post neoadjuvant therapy, none of the PET/CT variables of lymph nodes were related to prognosis. On the other hand, all primary tumor volumetric variables were related to overall survival. The MTV (HR: 4.66; 95% CI: 1.54-14.08) and TLG (HR: 4.86; 95% CI: 1.66-14.26) of the primary tumor post neoadjuvant therapy and the variations in MTV (HR: 2.95; 95% CI: 1.01-3.52) and TLG (HR: 3.49; 95% CI: 1.01-3.52) of the primary tumor pre-to-post-neoadjuvant therapy were prognostic variables. Conclusion: In patients with esophageal cancer, the burden of disease in suspicious lymph nodes and the primary tumor prior to therapy and the residual burden of disease in the primary tumor post therapy assessed by PET/CT were associated with prognosis.


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