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  • 2021년 03월호
    [Cancer Metab.] Prognostic value of metabolic tumor volume and total lesion glycolysis on preoperative 18 F-FDG PET/CT in patients with localized primary gastrointestinal stromal tumors

    연세의대 / 황상현, 조응혁*

  • 출처
    Cancer Metab.
  • 등재일
    2021 Jan 28
  • 저널이슈번호
    9(1):8. doi: 10.1186/s40170-021-00244-x.
  • 내용

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    Abstract
    Background: This study aimed to evaluate the prognostic value of pretreatment 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) in patients with localized primary gastrointestinal stromal tumors (GISTs) and to compare the predictive values of 18F-FDG PET/CT parameters with those of clinicopathological prognostic factors.

    Methods: Sixty-two localized GIST patients who underwent staging with 18F-FDG PET/CT from January 2007 to December 2013 before surgery were retrospectively enrolled. A volume of interest with a standardized uptake value (SUV) threshold of 2.5 was used to determine the metabolic tumor volume (MTV) and total lesion glycolysis (TLG). These metabolic indices, along with the maximum SUV (SUVmax), were analyzed to evaluate recurrence-free survival (RFS). Other significant clinical and pathologic indices were also retrospectively reviewed for RFS analysis.

    Results: Patients were followed up for a median of 42.0 months (range, 5.6-111.5). During the follow-up period, 13 patients (21.0%) experienced disease recurrence. In univariate analysis, tumor size (> 5 cm), mitotic count (> 5/high-power field), modified National Institutes of Health (NIH) consensus criteria, adjuvant imatinib treatment, SUVmax (≥ 7.04), MTV (≥ 50.76 cm3), and TLG (≥ 228.79 g) were significant prognostic factors affecting RFS (p < 0.05). In multivariate analysis, only MTV (hazard ratio, 17.69; 95% confidence interval [CI], 2.03-154.17, p = 0.009) and TLG (hazard ratio, 20.48; 95% CI, 2.19-191.16, p = 0.008) were independent prognostic factors for RFS. The 5-year RFS rates were 96.4% and 96.6% in patients with a low MTV and TLG and 27.3% and 23.6% in patients with a high MTV and TLG, respectively (p < 0.001).

    Conclusion: MTV and TLG are independent prognostic factors for predicting recurrence in patients with localized primary GIST. Patients with a high MTV or TLG are at risk for poor prognosis and should be closely observed for disease recurrence.

     

     

    Affiliations

    Sang Hyun Hwang  1 , Minkyu Jung  2 , Yong Hyu Jeong  3 , KwanHyeong Jo  4 , Soyoung Kim  5 , Jiyoung Wang  1 , Arthur Cho  6
    1 Department of Nuclear Medicine, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
    2 Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Republic of Korea.
    3 Department of Nuclear Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
    4 Department of Nuclear Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea.
    5 Department of Nuclear Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
    6 Department of Nuclear Medicine, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea. ARTYCHO@yuhs.ac.

  • 키워드
    18F-Fluorodeoxyglucose; Gastrointestinal stromal tumor; Metabolic tumor volume; PET; Prognosis.
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