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The prognostic value of volume-based parameters using18F-FDG PET/CT in gastric cancer according to HER2 status

Authors
 Ji Soo Park  ;  Nare Lee  ;  Seung Hoon Beom  ;  Hyo Song Kim  ;  Choong-kun Lee  ;  Sun Young Rha  ;  Hyun Cheol Chung  ;  Mijin Yun  ;  Arthur Cho  ;  Minkyu Jung 
Citation
 Gastric Cancer, Vol.21(2) : 213-224, 2018 
Journal Title
 Gastric Cancer 
ISSN
 1436-3291 
Issue Date
2018
Keywords
FDG ; Gastric cancer ; HER2 ; PET/CT ; Volume-based parameter
Abstract
BACKGROUND: We aimed to find the clinical value of metastatic tumor burden evaluated with F18-FDG PET/CT in gastric cancer patients, considering the human epidermal growth factor receptor 2 (HER2) status. METHODS: We retrospectively reviewed 124 patients with locally advanced or metastatic gastric cancer at Yonsei Cancer Center between January 2006 and December 2014 who had undergone baseline FDG PET/CT before first-line chemotherapy. We measured the maximum standardized uptake value from the primary tumor (SUVmax) and whole-body (WB) PET/CT parameters, including WB SUVmax, WB SUVmean, WB metabolic tumor volume (WB MTV), and WB total lesion glycolysis (WB TLG), in all metabolically active metastatic lesions (SUV threshold ≥2.5 or 40% isocontour for ≤2.5), and we determined their association with patient survival outcomes. RESULTS: SUVmax was higher in HER2-positive gastric cancers (median 12.1, range 3.4-34.6) compared to HER-2 negative (7.4, 1.6-39.1, P < 0.001). Among all patients, WB TLG > 600, which is indicative of a high metastatic tumor burden, showed worse progression-free survival (PFS) [hazard ratio (HR), 2.003; 95% CI, 1.300-3.086; P = 0.002] and overall survival (OS) (HR, 3.001; 95% CI, 1.950-4.618; P < 0.001) than did WB TLG ≤ 600. Among HER2-positive gastric cancer patients treated with trastuzumab, higher metabolic tumor burden predicted worse OS, but not PFS. CONCLUSIONS: HER2-positive gastric cancers had higher SUVmax compared to HER2-negative gastric cancers. In both HER2-negative patients and -positive patients receiving trastuzumab, FDG PET/CT volume-based parameters may have a role in further stratifying the prognosis of stage IV gastric cancer.
Full Text
https://link.springer.com/article/10.1007%2Fs10120-017-0739-0
DOI
10.1007/s10120-017-0739-0
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
김효송(Kim, Hyo Song) ORCID logo https://orcid.org/0000-0002-0625-9828
라선영(Rha, Sun Young) ORCID logo https://orcid.org/0000-0002-2512-4531
박지수(Park, Ji Soo) ORCID logo https://orcid.org/0000-0002-0023-7740
범승훈(Beom, Seung Hoon) ORCID logo https://orcid.org/0000-0001-7036-3753
윤미진(Yun, Mi Jin) ORCID logo https://orcid.org/0000-0002-1712-163X
이충근(Lee, Choong Kun)
정민규(Jung, Min Kyu) ORCID logo https://orcid.org/0000-0001-8281-3387
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
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/163178
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