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Prognostic Value of FDG Uptake of Portal Vein Tumor Thrombosis in Patients With Locally Advanced Hepatocellular Carcinoma

Authors
 Lee, Jeong Won  ;  Hwang, Sang Hyun  ;  Kim, Do Young  ;  Han, Kwang-Hyub  ;  Yun, Mijin 
Citation
 Clinical Nuclear Medicine, Vol.42(1) : e35-e40, 2017 
Journal Title
 Clinical Nuclear Medicine 
ISSN
 0363-9762 
Issue Date
2017
MeSH
Adult ; Aged ; Aged, 80 and over ; Antineoplastic Agents/therapeutic use ; Carcinoma, Hepatocellular/complications ; Carcinoma, Hepatocellular/diagnostic imaging* ; Carcinoma, Hepatocellular/therapy ; Chemoembolization, Therapeutic/methods ; Chemoradiotherapy/methods ; Disease-Free Survival ; Female ; Fluorodeoxyglucose F18 ; Humans ; Infusions, Intra-Arterial ; Liver Neoplasms/complications ; Liver Neoplasms/diagnostic imaging* ; Liver Neoplasms/therapy ; Male ; Middle Aged ; Portal Vein/diagnostic imaging* ; Positron Emission Tomography Computed Tomography ; Prognosis ; Radiopharmaceuticals ; Retrospective Studies ; Venous Thrombosis/diagnostic imaging* ; Venous Thrombosis/etiology
Abstract
PURPOSE: This study aimed to evaluate the prognostic value of F-FDG uptake of portal vein tumor thrombosis (PVTT) for predicting progression-free survival (PFS) and overall survival (OS) in patients with locally advanced hepatocellular carcinoma (HCC). METHODS: The study retrospectively included 166 HCC patients with PVTT and no extrahepatic metastases who underwent staging FDG PET/CT. Tumor-to-liver uptake ratio (TLR) and PVTT-to-liver uptake ratio (PLR) were measured for each patient, and the prognostic values of clinical factors, TLR, and PLR were assessed. Furthermore, patients were classified into 2 subgroups according to TLR, and the prognostic value of PLR was evaluated in each subgroup. RESULTS: Median PFS and OS were 6.2 and 10.1 months, respectively. On multivariate analysis, tumor size (P = 0.006) and PLR (P = 0.03) were independent prognostic factors for PFS, whereas Child-Pugh class (P = 0.02) and PLR (P = 0.02) were independent prognostic factors for OS. Tumor-to-liver uptake ratio was a significant prognostic factor for PFS and OS on univariate analysis but failed to show significance on multivariate analysis. In both patient subgroups with low and high TLR, PLR remained a significant prognostic factor for predicting OS (P = 0.04 for all). CONCLUSIONS: FDG uptake of PVTT, but not FDG uptake of HCC, is an independent prognostic factor for PFS and OS in HCC patients with PVTT and no extrahepatic metastasis. Given the prognostic significance, it is strongly encouraged to use FDG uptake of PVTT in further risk stratification for HCC patients with PVTT.
Full Text
http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&AN=00003072-201701000-00030&LSLINK=80&D=ovft
DOI
10.1097/RLU.0000000000001422
Appears in Collections:
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
김도영(Kim, Do Young)
윤미진(Yun, Mi Jin) ORCID logo https://orcid.org/0000-0002-1712-163X
한광협(Han, Kwang-Hyub) ORCID logo https://orcid.org/0000-0003-3960-6539
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/160808
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