Risk stratification for locally advanced hepatocellular carcinoma using pretreatment alpha-foetoprotein and 18F-fluoro-2-deoxyglucose positron emission tomography

Woo Joong Rhee, Sang Hyun Hwang, Hwa Kyung Byun, Mijin Yun, KwangHyub Han, Jinsil Seong

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background & Aims: We investigated the significance of 18F-fluoro-2-deoxyglucose positron emission tomography (18F-FDG PET) parameters and alpha-foetoprotein (AFP) levels in patients with locally advanced hepatocellular carcinoma (LA-HCC). Methods: We retrospectively analysed data of 228 patients with LA-HCC who underwent pretreatment 18F-FDG PET between January 2003 and December 2013. All patients were treated using liver-directed therapy involving radiotherapy. The maximum standardized uptake values (SUVs) and tumour-to-extratumoural liver SUV ratios were calculated, and pretreatment AFP values were obtained. Results: Patients were divided into high and low maximum SUV (SUVmax) groups according to a SUV cut-off of 4.825 determined via receiver-operating characteristic analysis. High AFP level (>550 ng/mL) and high SUVmax were significant predictors of overall and progression-free survival. Better treatment responses and longer median progression-free and overall survival were observed in the low SUVmax group, compared to the high SUVmax group. Similar results were obtained for SUV ratio-based (cut-off value: 2.355) and AFP-based analyses (cut-off value: 550 ng/mL). Three risk groups were identified using the double biomarkers of SUVmax and AFP value as strong prognosticators predictive of survival outcomes. This risk stratification was identified as a prognosticator of survival outcomes, even after subgroup analyses. Furthermore, in high risk group, significantly high extrahepatic failure was shown while in low risk group, significantly low intrahepatic failure. Conclusions: Clinical significance of double biomarkers, SUV and AFP, could be translated into risk stratification for LA-HCC. It could be a valuable tool for survival outcome prediction.

Original languageEnglish
Pages (from-to)592-599
Number of pages8
JournalLiver International
Volume37
Issue number4
DOIs
Publication statusPublished - 2017 Apr 1

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Deoxyglucose
alpha-Fetoproteins
Positron-Emission Tomography
Hepatocellular Carcinoma
Disease-Free Survival
Survival
Biomarkers
Liver
ROC Curve
Radiotherapy
Therapeutics
Neoplasms

All Science Journal Classification (ASJC) codes

  • Hepatology

Cite this

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title = "Risk stratification for locally advanced hepatocellular carcinoma using pretreatment alpha-foetoprotein and 18F-fluoro-2-deoxyglucose positron emission tomography",
abstract = "Background & Aims: We investigated the significance of 18F-fluoro-2-deoxyglucose positron emission tomography (18F-FDG PET) parameters and alpha-foetoprotein (AFP) levels in patients with locally advanced hepatocellular carcinoma (LA-HCC). Methods: We retrospectively analysed data of 228 patients with LA-HCC who underwent pretreatment 18F-FDG PET between January 2003 and December 2013. All patients were treated using liver-directed therapy involving radiotherapy. The maximum standardized uptake values (SUVs) and tumour-to-extratumoural liver SUV ratios were calculated, and pretreatment AFP values were obtained. Results: Patients were divided into high and low maximum SUV (SUVmax) groups according to a SUV cut-off of 4.825 determined via receiver-operating characteristic analysis. High AFP level (>550 ng/mL) and high SUVmax were significant predictors of overall and progression-free survival. Better treatment responses and longer median progression-free and overall survival were observed in the low SUVmax group, compared to the high SUVmax group. Similar results were obtained for SUV ratio-based (cut-off value: 2.355) and AFP-based analyses (cut-off value: 550 ng/mL). Three risk groups were identified using the double biomarkers of SUVmax and AFP value as strong prognosticators predictive of survival outcomes. This risk stratification was identified as a prognosticator of survival outcomes, even after subgroup analyses. Furthermore, in high risk group, significantly high extrahepatic failure was shown while in low risk group, significantly low intrahepatic failure. Conclusions: Clinical significance of double biomarkers, SUV and AFP, could be translated into risk stratification for LA-HCC. It could be a valuable tool for survival outcome prediction.",
author = "Rhee, {Woo Joong} and Hwang, {Sang Hyun} and Byun, {Hwa Kyung} and Mijin Yun and KwangHyub Han and Jinsil Seong",
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Risk stratification for locally advanced hepatocellular carcinoma using pretreatment alpha-foetoprotein and 18F-fluoro-2-deoxyglucose positron emission tomography. / Rhee, Woo Joong; Hwang, Sang Hyun; Byun, Hwa Kyung; Yun, Mijin; Han, KwangHyub; Seong, Jinsil.

In: Liver International, Vol. 37, No. 4, 01.04.2017, p. 592-599.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Risk stratification for locally advanced hepatocellular carcinoma using pretreatment alpha-foetoprotein and 18F-fluoro-2-deoxyglucose positron emission tomography

AU - Rhee, Woo Joong

AU - Hwang, Sang Hyun

AU - Byun, Hwa Kyung

AU - Yun, Mijin

AU - Han, KwangHyub

AU - Seong, Jinsil

PY - 2017/4/1

Y1 - 2017/4/1

N2 - Background & Aims: We investigated the significance of 18F-fluoro-2-deoxyglucose positron emission tomography (18F-FDG PET) parameters and alpha-foetoprotein (AFP) levels in patients with locally advanced hepatocellular carcinoma (LA-HCC). Methods: We retrospectively analysed data of 228 patients with LA-HCC who underwent pretreatment 18F-FDG PET between January 2003 and December 2013. All patients were treated using liver-directed therapy involving radiotherapy. The maximum standardized uptake values (SUVs) and tumour-to-extratumoural liver SUV ratios were calculated, and pretreatment AFP values were obtained. Results: Patients were divided into high and low maximum SUV (SUVmax) groups according to a SUV cut-off of 4.825 determined via receiver-operating characteristic analysis. High AFP level (>550 ng/mL) and high SUVmax were significant predictors of overall and progression-free survival. Better treatment responses and longer median progression-free and overall survival were observed in the low SUVmax group, compared to the high SUVmax group. Similar results were obtained for SUV ratio-based (cut-off value: 2.355) and AFP-based analyses (cut-off value: 550 ng/mL). Three risk groups were identified using the double biomarkers of SUVmax and AFP value as strong prognosticators predictive of survival outcomes. This risk stratification was identified as a prognosticator of survival outcomes, even after subgroup analyses. Furthermore, in high risk group, significantly high extrahepatic failure was shown while in low risk group, significantly low intrahepatic failure. Conclusions: Clinical significance of double biomarkers, SUV and AFP, could be translated into risk stratification for LA-HCC. It could be a valuable tool for survival outcome prediction.

AB - Background & Aims: We investigated the significance of 18F-fluoro-2-deoxyglucose positron emission tomography (18F-FDG PET) parameters and alpha-foetoprotein (AFP) levels in patients with locally advanced hepatocellular carcinoma (LA-HCC). Methods: We retrospectively analysed data of 228 patients with LA-HCC who underwent pretreatment 18F-FDG PET between January 2003 and December 2013. All patients were treated using liver-directed therapy involving radiotherapy. The maximum standardized uptake values (SUVs) and tumour-to-extratumoural liver SUV ratios were calculated, and pretreatment AFP values were obtained. Results: Patients were divided into high and low maximum SUV (SUVmax) groups according to a SUV cut-off of 4.825 determined via receiver-operating characteristic analysis. High AFP level (>550 ng/mL) and high SUVmax were significant predictors of overall and progression-free survival. Better treatment responses and longer median progression-free and overall survival were observed in the low SUVmax group, compared to the high SUVmax group. Similar results were obtained for SUV ratio-based (cut-off value: 2.355) and AFP-based analyses (cut-off value: 550 ng/mL). Three risk groups were identified using the double biomarkers of SUVmax and AFP value as strong prognosticators predictive of survival outcomes. This risk stratification was identified as a prognosticator of survival outcomes, even after subgroup analyses. Furthermore, in high risk group, significantly high extrahepatic failure was shown while in low risk group, significantly low intrahepatic failure. Conclusions: Clinical significance of double biomarkers, SUV and AFP, could be translated into risk stratification for LA-HCC. It could be a valuable tool for survival outcome prediction.

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U2 - 10.1111/liv.13297

DO - 10.1111/liv.13297

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SN - 1478-3223

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