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

Jeong Won Lee, Sang Hyun Hwang, Do Young Kim, Kwang Hyub Han, Mijin Yun

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Purpose This study aimed to evaluate the prognostic value of 18F-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.

Original languageEnglish
Pages (from-to)e35-e40
JournalClinical nuclear medicine
Volume42
Issue number1
DOIs
Publication statusPublished - 2017 Jan 1

Fingerprint

Portal Vein
Hepatocellular Carcinoma
Thrombosis
Liver
Neoplasms
Disease-Free Survival
Survival
Multivariate Analysis
Neoplasm Metastasis
Fluorodeoxyglucose F18

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging

Cite this

@article{d09ba4be25e34a93b65f669dfd3f231e,
title = "Prognostic Value of FDG Uptake of Portal Vein Tumor Thrombosis in Patients with Locally Advanced Hepatocellular Carcinoma",
abstract = "Purpose This study aimed to evaluate the prognostic value of 18F-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.",
author = "Lee, {Jeong Won} and Hwang, {Sang Hyun} and Kim, {Do Young} and Han, {Kwang Hyub} and Mijin Yun",
year = "2017",
month = "1",
day = "1",
doi = "10.1097/RLU.0000000000001422",
language = "English",
volume = "42",
pages = "e35--e40",
journal = "Clinical Nuclear Medicine",
issn = "0363-9762",
publisher = "Lippincott Williams and Wilkins",
number = "1",

}

Prognostic Value of FDG Uptake of Portal Vein Tumor Thrombosis in Patients with Locally Advanced Hepatocellular Carcinoma. / Lee, Jeong Won; Hwang, Sang Hyun; Kim, Do Young; Han, Kwang Hyub; Yun, Mijin.

In: Clinical nuclear medicine, Vol. 42, No. 1, 01.01.2017, p. e35-e40.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Prognostic Value of FDG Uptake of Portal Vein Tumor Thrombosis in Patients with Locally Advanced Hepatocellular Carcinoma

AU - Lee, Jeong Won

AU - Hwang, Sang Hyun

AU - Kim, Do Young

AU - Han, Kwang Hyub

AU - Yun, Mijin

PY - 2017/1/1

Y1 - 2017/1/1

N2 - Purpose This study aimed to evaluate the prognostic value of 18F-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.

AB - Purpose This study aimed to evaluate the prognostic value of 18F-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.

UR - http://www.scopus.com/inward/record.url?scp=84992316532&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84992316532&partnerID=8YFLogxK

U2 - 10.1097/RLU.0000000000001422

DO - 10.1097/RLU.0000000000001422

M3 - Article

C2 - 27775940

AN - SCOPUS:84992316532

VL - 42

SP - e35-e40

JO - Clinical Nuclear Medicine

JF - Clinical Nuclear Medicine

SN - 0363-9762

IS - 1

ER -