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Prognostic value of (18)F-fluorodeoxyglucose positron emission tomography in patients with gastric neuroendocrine carcinoma and mixed adenoneuroendocrine carcinoma.

 Sun Min Lim  ;  Hyunki Kim  ;  Beodeul Kang  ;  Hyo Song Kim  ;  Sun Young Rha  ;  Sung Hoon Noh  ;  Woo Jin Hyung  ;  Jae-Ho Cheong  ;  Hyoung-Il Kim  ;  Hyun Cheol Chung  ;  Mijin Yun  ;  Arthur Cho  ;  Minkyu Jung 
 Annals of Nuclear Medicine, Vol.30(4) : 279-286, 2016 
Journal Title
 Annals of Nuclear Medicine 
Issue Date
Adenocarcinoma/diagnostic imaging* ; Adenocarcinoma/metabolism ; Adenocarcinoma/pathology ; Adult ; Aged ; Aged, 80 and over ; Carcinoma, Neuroendocrine/diagnostic imaging* ; Carcinoma, Neuroendocrine/metabolism ; Carcinoma, Neuroendocrine/pathology ; Female ; Fluorodeoxyglucose F18* ; Humans ; Male ; Middle Aged ; Neoplasm Metastasis ; Positron Emission Tomography Computed Tomography* ; Prognosis ; Retrospective Studies ; Stomach Neoplasms/diagnostic imaging* ; Stomach Neoplasms/metabolism ; Stomach Neoplasms/pathology ; Survival Analysis
18F-FDG PET/CT ; Gastric ; Mixed adenoneuroendocine carcinoma ; Neuroendocrine carcinoma ; Survival
OBJECTIVE: Gastric neuroendocrine carcinomas (NEC) and mixed adenoneuroendocrine carcinoma (MANEC) are very rare, aggressive tumors of the stomach. We aimed to examine predictive role of pretreatment (18)F-FDG PET/CT-assessed metabolic parameter of primary tumors and metastases in patients with gastric NEC and MANEC. METHODS: We conducted a review of the 27 patients with histopathologically confirmed NECs (n = 10) and MANEC (n = 17) of the stomach at our institution between January 2005 and December 2012. All patients underwent (18)F-FDG-PET examination at diagnosis. Metabolic parameters [SUVmax, SUVmean, metabolic tumor volume (MTV) and total lesion glycolysis (TLG)] of the primary tumor and metastases on baseline PET/CT were analyzed. RESULTS: The median follow-up duration was 39.4 months (95 % CI 20.0-58.1 months) and the median overall survival (OS) was 25.7 months (95 % CI 14.1-37.2 months). All gastric lesions were well visualized (average SUVmax = 12.0, range 3.0-41.8). When subjects were divided into two groups by ROC cut-off value of 210.9 and 612, patients with high TLG in primary lesion and metastases showed poorer prognosis compared to low TLG patients (P = 0.09, P = 0.002, respectively). In the sub-analysis of patients with metastasis (n = 12), patients with high TLG in whole body tumor showed significantly shorter OS compared to those with low TLG (31.7 ± 11.4 vs. 7.2 ± 2.1 months, P = 0.006). CONCLUSION: (18)F-FDG PET/CT is useful in evaluating prognosis of advanced gastric cancer with neuroendocrine carcinoma components. Baseline MTV of primary gastric cancer with metastatic disease, and MTV, TLG of metastases may be prognostic markers in patients with gastric NEC and MANEC.
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1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Nuclear Medicine (핵의학교실) > 1. Journal Papers
Yonsei Authors
김현기(Kim, Hyunki) ORCID logo https://orcid.org/0000-0003-2292-5584
김형일(Kim, Hyoung Il) ORCID logo https://orcid.org/0000-0002-6134-4523
김효송(Kim, Hyo Song) ORCID logo https://orcid.org/0000-0002-0625-9828
노성훈(Noh, Sung Hoon) ORCID logo https://orcid.org/0000-0003-4386-6886
라선영(Rha, Sun Young) ORCID logo https://orcid.org/0000-0002-2512-4531
윤미진(Yun, Mi Jin) ORCID logo https://orcid.org/0000-0002-1712-163X
정민규(Jung, Min Kyu) ORCID logo https://orcid.org/0000-0001-8281-3387
정재호(Cheong, Jae Ho) ORCID logo https://orcid.org/0000-0002-1703-1781
정현철(Chung, Hyun Cheol) ORCID logo https://orcid.org/0000-0002-0920-9471
조응혁(Cho, Arthur Eung Hyuck) ORCID logo https://orcid.org/0000-0001-8670-2473
형우진(Hyung, Woo Jin) ORCID logo https://orcid.org/0000-0002-8593-9214
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