Prognostic significance of 18 F-FDG uptake in hepatocellular carcinoma treated with transarterial chemoembolization or concurrent chemoradiotherapy: A multicenter retrospective cohort study

Jeong Won Lee, Jin Kyoung Oh, Yong An Chung, Sae Jung Na, Seung Hyup Hyun, Il Ki Hong, Jae Seon Eo, Bong Il Song, Tae Sung Kim, doyoung kim, Seungup Kim, Dae Hyuk Moon, Jong Doo Lee, Mijin Yun

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

This study aimed to assess the prognostic value of 18 F-FDG uptake in hepatocellular carcinoma (HCC) patients who had transarterial chemoembolization (TACE) or concurrent intraarterial chemotherapy with external-beam radiotherapy (CCRT) and to compare the prognosis between patients treated with TACE and those with CCRT according to 18 F-FDG uptake. Methods: Two hundred fourteen intermediate- to-advanced-stage HCC patients without extrahepatic metastasis who underwent staging 18 F-FDG PET/CT before TACE (153 patients) or CCRT (61 patients) were recruited from 7 hospitals. Progressionfree survival (PFS) and overall survival (OS) were compared using an optimal cutoff value for tumor-to-normal liver uptake ratio (TLR). Further, PFS and OS were compared according to treatment modalities (TACE vs. CCRT) using the same TLR cutoff value. Results: On multivariate analysis, age and TLR were independent prognostic factors for PFS (P < 0.050). For OS, Child-Pugh classification and TLR were independent prognostic factors (P < 0.050). When the TLR was greater than 2.0, patients treated with CCRT showed significantly better PFS and OS than those treated with TACE after adjusting for tumor size and number (P = 0.014, for all). In contrast, there was no significant difference in PFS and OS between patients treated with TACE or CCRT when the TLR was 2.0 or less. Conclusion: 18 F-FDG uptake was an independent prognostic factor for PFS and OS in HCC patients treated with TACE or CCRT. Especially, in HCCs with high 18 F-FDG uptake, patients treated with CCRT showed better survival than those treated with TACE. 18 F-FDG PET/CT may help determine the treatment modality for intermediate-to-advanced-stage HCCs.

Original languageEnglish
Pages (from-to)509-516
Number of pages8
JournalJournal of Nuclear Medicine
Volume57
Issue number4
DOIs
Publication statusPublished - 2016 Apr 1

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Chemoradiotherapy
Hepatocellular Carcinoma
Cohort Studies
Retrospective Studies
Survival
Liver
Neoplasms
Radiotherapy
Multivariate Analysis

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging

Cite this

Lee, Jeong Won ; Oh, Jin Kyoung ; Chung, Yong An ; Na, Sae Jung ; Hyun, Seung Hyup ; Hong, Il Ki ; Eo, Jae Seon ; Song, Bong Il ; Kim, Tae Sung ; kim, doyoung ; Kim, Seungup ; Moon, Dae Hyuk ; Lee, Jong Doo ; Yun, Mijin. / Prognostic significance of 18 F-FDG uptake in hepatocellular carcinoma treated with transarterial chemoembolization or concurrent chemoradiotherapy : A multicenter retrospective cohort study. In: Journal of Nuclear Medicine. 2016 ; Vol. 57, No. 4. pp. 509-516.
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title = "Prognostic significance of 18 F-FDG uptake in hepatocellular carcinoma treated with transarterial chemoembolization or concurrent chemoradiotherapy: A multicenter retrospective cohort study",
abstract = "This study aimed to assess the prognostic value of 18 F-FDG uptake in hepatocellular carcinoma (HCC) patients who had transarterial chemoembolization (TACE) or concurrent intraarterial chemotherapy with external-beam radiotherapy (CCRT) and to compare the prognosis between patients treated with TACE and those with CCRT according to 18 F-FDG uptake. Methods: Two hundred fourteen intermediate- to-advanced-stage HCC patients without extrahepatic metastasis who underwent staging 18 F-FDG PET/CT before TACE (153 patients) or CCRT (61 patients) were recruited from 7 hospitals. Progressionfree survival (PFS) and overall survival (OS) were compared using an optimal cutoff value for tumor-to-normal liver uptake ratio (TLR). Further, PFS and OS were compared according to treatment modalities (TACE vs. CCRT) using the same TLR cutoff value. Results: On multivariate analysis, age and TLR were independent prognostic factors for PFS (P < 0.050). For OS, Child-Pugh classification and TLR were independent prognostic factors (P < 0.050). When the TLR was greater than 2.0, patients treated with CCRT showed significantly better PFS and OS than those treated with TACE after adjusting for tumor size and number (P = 0.014, for all). In contrast, there was no significant difference in PFS and OS between patients treated with TACE or CCRT when the TLR was 2.0 or less. Conclusion: 18 F-FDG uptake was an independent prognostic factor for PFS and OS in HCC patients treated with TACE or CCRT. Especially, in HCCs with high 18 F-FDG uptake, patients treated with CCRT showed better survival than those treated with TACE. 18 F-FDG PET/CT may help determine the treatment modality for intermediate-to-advanced-stage HCCs.",
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Prognostic significance of 18 F-FDG uptake in hepatocellular carcinoma treated with transarterial chemoembolization or concurrent chemoradiotherapy : A multicenter retrospective cohort study. / Lee, Jeong Won; Oh, Jin Kyoung; Chung, Yong An; Na, Sae Jung; Hyun, Seung Hyup; Hong, Il Ki; Eo, Jae Seon; Song, Bong Il; Kim, Tae Sung; kim, doyoung; Kim, Seungup; Moon, Dae Hyuk; Lee, Jong Doo; Yun, Mijin.

In: Journal of Nuclear Medicine, Vol. 57, No. 4, 01.04.2016, p. 509-516.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Prognostic significance of 18 F-FDG uptake in hepatocellular carcinoma treated with transarterial chemoembolization or concurrent chemoradiotherapy

T2 - A multicenter retrospective cohort study

AU - Lee, Jeong Won

AU - Oh, Jin Kyoung

AU - Chung, Yong An

AU - Na, Sae Jung

AU - Hyun, Seung Hyup

AU - Hong, Il Ki

AU - Eo, Jae Seon

AU - Song, Bong Il

AU - Kim, Tae Sung

AU - kim, doyoung

AU - Kim, Seungup

AU - Moon, Dae Hyuk

AU - Lee, Jong Doo

AU - Yun, Mijin

PY - 2016/4/1

Y1 - 2016/4/1

N2 - This study aimed to assess the prognostic value of 18 F-FDG uptake in hepatocellular carcinoma (HCC) patients who had transarterial chemoembolization (TACE) or concurrent intraarterial chemotherapy with external-beam radiotherapy (CCRT) and to compare the prognosis between patients treated with TACE and those with CCRT according to 18 F-FDG uptake. Methods: Two hundred fourteen intermediate- to-advanced-stage HCC patients without extrahepatic metastasis who underwent staging 18 F-FDG PET/CT before TACE (153 patients) or CCRT (61 patients) were recruited from 7 hospitals. Progressionfree survival (PFS) and overall survival (OS) were compared using an optimal cutoff value for tumor-to-normal liver uptake ratio (TLR). Further, PFS and OS were compared according to treatment modalities (TACE vs. CCRT) using the same TLR cutoff value. Results: On multivariate analysis, age and TLR were independent prognostic factors for PFS (P < 0.050). For OS, Child-Pugh classification and TLR were independent prognostic factors (P < 0.050). When the TLR was greater than 2.0, patients treated with CCRT showed significantly better PFS and OS than those treated with TACE after adjusting for tumor size and number (P = 0.014, for all). In contrast, there was no significant difference in PFS and OS between patients treated with TACE or CCRT when the TLR was 2.0 or less. Conclusion: 18 F-FDG uptake was an independent prognostic factor for PFS and OS in HCC patients treated with TACE or CCRT. Especially, in HCCs with high 18 F-FDG uptake, patients treated with CCRT showed better survival than those treated with TACE. 18 F-FDG PET/CT may help determine the treatment modality for intermediate-to-advanced-stage HCCs.

AB - This study aimed to assess the prognostic value of 18 F-FDG uptake in hepatocellular carcinoma (HCC) patients who had transarterial chemoembolization (TACE) or concurrent intraarterial chemotherapy with external-beam radiotherapy (CCRT) and to compare the prognosis between patients treated with TACE and those with CCRT according to 18 F-FDG uptake. Methods: Two hundred fourteen intermediate- to-advanced-stage HCC patients without extrahepatic metastasis who underwent staging 18 F-FDG PET/CT before TACE (153 patients) or CCRT (61 patients) were recruited from 7 hospitals. Progressionfree survival (PFS) and overall survival (OS) were compared using an optimal cutoff value for tumor-to-normal liver uptake ratio (TLR). Further, PFS and OS were compared according to treatment modalities (TACE vs. CCRT) using the same TLR cutoff value. Results: On multivariate analysis, age and TLR were independent prognostic factors for PFS (P < 0.050). For OS, Child-Pugh classification and TLR were independent prognostic factors (P < 0.050). When the TLR was greater than 2.0, patients treated with CCRT showed significantly better PFS and OS than those treated with TACE after adjusting for tumor size and number (P = 0.014, for all). In contrast, there was no significant difference in PFS and OS between patients treated with TACE or CCRT when the TLR was 2.0 or less. Conclusion: 18 F-FDG uptake was an independent prognostic factor for PFS and OS in HCC patients treated with TACE or CCRT. Especially, in HCCs with high 18 F-FDG uptake, patients treated with CCRT showed better survival than those treated with TACE. 18 F-FDG PET/CT may help determine the treatment modality for intermediate-to-advanced-stage HCCs.

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