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Prognostic value of (18)F-fluorodeoxyglucose positron emission tomography/computed tomography in patients with Barcelona Clinic Liver Cancer stages 0 and A hepatocellular carcinomas: a multicenter retrospective cohort study

Authors
 Seung Hyup Hyun  ;  Jae Seon Eo  ;  Jeong Won Lee  ;  Joon Young Choi  ;  Kyung-Han Lee  ;  Sae Jung Na  ;  Il Ki Hong  ;  Jin Kyoung Oh  ;  Yong An Chung  ;  Bong-Il Song  ;  Tae-Sung Kim  ;  Kyung Sik Kim  ;  Dae Hyuk Moon  ;  Mijin Yun 
Citation
 European Journal of Nuclear Medicine and Molecular Imaging, Vol.43(9) : 1638-1645, 2016 
Journal Title
 European Journal of Nuclear Medicine and Molecular Imaging 
ISSN
 1619-7070 
Issue Date
2016
MeSH
Aged ; Biological Transport ; Carcinoma, Hepatocellular/diagnostic imaging* ; Carcinoma, Hepatocellular/pathology* ; Cohort Studies ; Disease-Free Survival ; Female ; Fluorodeoxyglucose F18* ; Humans ; Kaplan-Meier Estimate ; Liver Neoplasms/diagnostic imaging* ; Liver Neoplasms/pathology* ; Male ; Middle Aged ; Neoplasm Staging ; Positron Emission Tomography Computed Tomography* ; Retrospective Studies
Keywords
FDG PET/CT ; Hepatocellular carcinoma ; Multicenter trial ; Prognosis ; Standardized uptake value
Abstract
PURPOSE: We evaluated the prognostic value of pretreatment (18)F-fluorodeoxyglucose positron emission tomography with computed tomography (FDG PET/CT) in patients with Barcelona Clinic Liver Cancer (BCLC) stage 0 or A hepatocellular carcinoma (HCC) who had received curative treatment or transarterial chemoembolization (TACE). METHODS: Between 2009 and 2010, 317 patients diagnosed with HCC at seven hospitals were enrolled. Among these, 195 patients underwent curative treatments including resection, liver transplantation, and radiofrequency ablation. TACE was performed in 122 patients. The tumor-to-normal liver standardized uptake value ratio (TLR) of the primary tumor was measured using pretreatment FDG PET/CT. The prognostic significance of TLR and other clinical variables was assessed using Cox regression models. Differences in the overall survival (OS) associated with TLR or other significant clinical factors were examined using the Kaplan-Meier method. RESULTS: Over a median follow-up period of 46 months, 77 patients died from cancer. In the curative cohort, higher TLR (≥2) was significantly associated with death (hazard ratio [HR]?=?2.68; 95 % CI, 1.16-6.15; P?=?0.020) in multivariable analysis. Patients with a higher TLR had significantly worse OS than patients with a lower TLR (5-year overall survival, 61 % vs. 79.4 %; P?=?0.006). In the TACE cohort, the Model for End-Stage Liver Disease (MELD) score (≥8) was a significant independent prognostic factor for OS (HR?=?3.34; 95 % CI, 1.49-7.48; P?=?0.003), whereas TLR was not associated with OS. The Kaplan-Meier curves showed significantly poorer OS in patients with higher MELD scores (≥8) than in those with lower MELD scores (5-year survival rate, 33.1 % vs. 79.6 %; P?<?0.001). CONCLUSIONS: Pretreatment TLR measured using FDG PET/CT was an independent prognostic factor for OS in patients with BCLC stage 0 or A HCC undergoing curative treatment. In contrast, underlying liver function appeared to be important in predicting the prognosis of patients undergoing TACE.
Full Text
https://link.springer.com/article/10.1007%2Fs00259-016-3348-y
DOI
10.1007/s00259-016-3348-y
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Nuclear Medicine (핵의학교실) > 1. Journal Papers
Yonsei Authors
김경식(Kim, Kyung Sik) ORCID logo https://orcid.org/0000-0001-9498-284X
윤미진(Yun, Mi Jin) ORCID logo https://orcid.org/0000-0002-1712-163X
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/152147
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