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Relationship Between 18F-FDG Uptake on PET and Recurrence Patterns After Curative Surgical Resection in Patients with Advanced Gastric Cancer

 Jeong Won Lee  ;  Kwanhyeong Jo  ;  Arthur Cho  ;  Sung Hoon Noh  ;  Jong Doo Lee  ;  Mijin Yun 
 JOURNAL OF NUCLEAR MEDICINE, Vol.56(10) : 1494-1500, 2015 
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Issue Date
Adult ; Aged ; Aged, 80 and over ; Disease-Free Survival ; Female ; Fluorodeoxyglucose F18 ; Gastrectomy ; Humans ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoadjuvant Therapy ; Neoplasm Recurrence, Local ; Positron-Emission Tomography/methods* ; Predictive Value of Tests ; Radiopharmaceuticals ; Retrospective Studies ; Stomach Neoplasms/diagnostic imaging* ; Stomach Neoplasms/surgery* ; Young Adult
18F-fluorodeoxyglucose ; advanced gastric cancer ; positron emission tomography ; prognosis ; recurrence
This study evaluated the predictive value of (18)F-FDG PET for distant metastasis-free survival and peritoneal recurrence-free survival as well as recurrence-free survival and overall survival after curative surgical resection in patients with advanced gastric cancer (AGC). METHODS: Two hundred seventy-nine patients with AGC who underwent preoperative (18)F-FDG PET and subsequent curative surgical resection were included. The tumor-to-normal liver uptake ratio (TLR) of cancer lesions was measured, and the prognostic significance of TLR and tumor factors for distant metastasis-free survival, peritoneal recurrence-free survival, recurrence-free survival, and overall survival was assessed. RESULTS: The 5-y recurrence-free survival, peritoneal recurrence-free survival, distant metastasis-free survival, and overall survival rates were 46.9%, 68.5%, 76.0%, and 58.1%, respectively. Depth of tumor invasion, lymph node metastasis, lymphovascular invasion, and TLR were independent prognostic factors for both recurrence-free survival and overall survival (P < 0.05). For distant metastasis-free survival, lymphovascular invasion and TLR were independent risk factors (P < 0.05). In patients with a TLR of 2.0 or less, the 5-y distant metastasis-free survival rate was 95.5%; in patients with a TLR greater than 2.0, the 5-y distant metastasis-free survival rate was 68.8%. For peritoneal recurrence-free survival, TLR showed no statistical significance (P = 0.7) whereas pT stage, lymph node metastasis, Lauren classification, and Bormann type were independent prognostic factors (P < 0.05). CONCLUSION: (18)F-FDG uptake of AGC is an independent prognostic factor for distant metastasis-free survival, recurrence-free survival, and overall survival. The possibility of distant metastasis during follow-up should be considered in patients with high (18)F-FDG uptake.
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1. College of Medicine (의과대학) > Dept. of Nuclear Medicine (핵의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Noh, Sung Hoon(노성훈) ORCID logo https://orcid.org/0000-0003-4386-6886
Yun, Mi Jin(윤미진) ORCID logo https://orcid.org/0000-0002-1712-163X
Cho, Arthur Eung Hyuck(조응혁) ORCID logo https://orcid.org/0000-0001-8670-2473
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