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A hierarchical prognostic model for risk stratification in patients with early breast cancer according to 18 F-fludeoxyglucose uptake and clinicopathological parameters

 Jongtae Cha  ;  Hyung Seok Park  ;  Dongwoo Kim  ;  Hyun Jeong Kim  ;  Min Jung Kim  ;  Young Up Cho  ;  Mijin Yun 
 Cancer Medicine, Vol.7(4) : 1127-1134, 2018 
Journal Title
 Cancer Medicine 
Issue Date
18F-FDG PET/CT ; classification and regression tree modeling ; early breast cancer ; recurrence-free survival ; risk model
This study was to investigate a hierarchical prognostic model using clinicopathological factors and 18 F-fludeoxyglucose (FDG) uptake on positron emission tomography/computed tomography (PET/CT) for recurrence-free survival (RFS) in patients with early breast cancer who underwent surgery without neoadjuvant chemotherapy. A total of 524 patients with early breast cancer were included. The Cox proportional hazards model was used with clinicopathological variables and maximum standardized uptake value (SUVmax) on PET/CT. After classification and regression tree (CART) modeling, RFS curves were estimated using the Kaplan-Meier method and differences in each risk layer were assessed using the log-rank test. During a median follow-up of 46.2 months, 31 (5.9%) patients experienced recurrence. The CART model identified four risk layers: group 1 (SUVmax ≤6.75 and tumor size ≤2.0 cm); group 2 (SUVmax ≤6.75 and Luminal A [LumA] or TN tumor >2.0 cm); group 3 (SUVmax ≤6.75 and Luminal B [LumB] or human epidermal growth factor receptor 2 [HER2]-enriched] tumor >2.0 cm); group 4 (SUVmax >6.75). Five-year RFS was as follows: 95.9% (group 1), 98% (group 2), 82.8% (group 3), and 85.4% (group 4). Group 3 or group 4 showed worse prognosis than group 1 or group 2 (group 1 vs. group 3: P = 0.040; group 1 vs. group 4: P < 0.001; group 2 vs. group 3: P = 0.016; group 2 vs. group 4: P < 0.001). High SUVmax (>6.75) in primary breast cancer was an independent factor for poor RFS. In patients with low SUVmax, LumB or HER2-enriched tumor >2 cm was also prognostic for poor RFS, similar to high SUVmax.
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1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Nuclear Medicine (핵의학교실)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실)
Yonsei Authors
김동우(Kim, Dongwoo) ORCID logo https://orcid.org/0000-0002-1723-604X
김민정(Kim, Min Jung) ORCID logo https://orcid.org/0000-0003-4949-1237
김현정(Kim, Hyun Jeong) ORCID logo https://orcid.org/0000-0002-3116-8848
박형석(Park, Hyung Seok) ORCID logo https://orcid.org/0000-0001-5322-6036
윤미진(Yun, Mi Jin) ORCID logo https://orcid.org/0000-0002-1712-163X
조영업(Cho, Young Up) ORCID logo https://orcid.org/0000-0003-2936-410X
차종태(Cha, Jongtae)
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