18F-fluorodeoxyglucose uptake on positron emission tomography as a prognostic predictor in locally advanced hepatocellular carcinoma

Beom Kyung Kim, Won Jun Kang, Ja Kyung Kim, Jinsil Seong, Junyong Park, doyoung kim, SangHoon Ahn, Do Youn Lee, Kwang Hoon Lee, Jong Doo Lee, KwangHyub Han

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Abstract

BACKGROUND: Metabolic activity assessed by 18F- fluorodeoxyglocuse-positron emission tomography (18F-FDG-PET) reflects biological aggressiveness and prognoses in various tumors. The authors present a correlation between tumor metabolic activity and clinical outcomes in patients with hepatocellular carcinoma (HCC). METHODS: Over a 3-year period (2005-2008), 135 locally advanced HCC patients were treated with localized concurrent chemoradiotherapy (CCRT; external beam radiotherapy at 45 grays for 5 weeks plus concurrent hepatic arterial infusion of 5-fluorouracil during the first and fifth week) followed by repetitive hepatic arterial infusional chemotherapy with 5-fluorouracil and cisplatin. Among them, the authors studied 107 who received 18F-FDG-PET before CCRT. Maximal standardized uptake values (SUVs) of tumors were calculated. RESULTS: The median maximal tumor SUV was 6.1 (range, 2.4-∼19.2). Patients with low maximal tumor SUVs (<6.1) had a higher disease control rate than those with high maximal tumor SUVs (≥6.1) (86.8% vs 68.5%, respectively, P =.023). Both median progression-free survival (PFS; 8.4 vs 5.2 months; P =.003) and overall survival (OS; 17.9 vs 11.3 months; P =.013) were significantly longer in the low maximal tumor SUV group than in the high maximal tumor SUV group, respectively. In multivariate analysis, low maximal tumor SUV and objective responses to CCRT remained significant for PFS and OS. The high maximal tumor SUV group was more likely to have extrahepatic metastasis within 6 months than the low maximal tumor SUV group (58.1% vs 26.8%, respectively; P <.001). Similar results were obtained for the maximal tumor SUV/normal liver maximal SUV ratio (<2 vs ≥2) concerning progression, death, and extrahepatic metastasis. CONCLUSIONS: Metabolic activity may be useful not only in predicting prognosis and treatment responses, but also in establishing optimal treatment plans in locally advanced HCC. Cancer 2011;.

Original languageEnglish
Pages (from-to)4779-4787
Number of pages9
JournalCancer
Volume117
Issue number20
DOIs
Publication statusPublished - 2011 Oct 15

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Fluorodeoxyglucose F18
Positron-Emission Tomography
Hepatocellular Carcinoma
Neoplasms
Fluorouracil
Liver
Neoplasm Metastasis
Chemoradiotherapy
Cisplatin
Disease-Free Survival
Reference Values
Radiotherapy
Multivariate Analysis

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

Cite this

Kim, Beom Kyung ; Kang, Won Jun ; Kim, Ja Kyung ; Seong, Jinsil ; Park, Junyong ; kim, doyoung ; Ahn, SangHoon ; Lee, Do Youn ; Lee, Kwang Hoon ; Lee, Jong Doo ; Han, KwangHyub. / 18F-fluorodeoxyglucose uptake on positron emission tomography as a prognostic predictor in locally advanced hepatocellular carcinoma. In: Cancer. 2011 ; Vol. 117, No. 20. pp. 4779-4787.
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title = "18F-fluorodeoxyglucose uptake on positron emission tomography as a prognostic predictor in locally advanced hepatocellular carcinoma",
abstract = "BACKGROUND: Metabolic activity assessed by 18F- fluorodeoxyglocuse-positron emission tomography (18F-FDG-PET) reflects biological aggressiveness and prognoses in various tumors. The authors present a correlation between tumor metabolic activity and clinical outcomes in patients with hepatocellular carcinoma (HCC). METHODS: Over a 3-year period (2005-2008), 135 locally advanced HCC patients were treated with localized concurrent chemoradiotherapy (CCRT; external beam radiotherapy at 45 grays for 5 weeks plus concurrent hepatic arterial infusion of 5-fluorouracil during the first and fifth week) followed by repetitive hepatic arterial infusional chemotherapy with 5-fluorouracil and cisplatin. Among them, the authors studied 107 who received 18F-FDG-PET before CCRT. Maximal standardized uptake values (SUVs) of tumors were calculated. RESULTS: The median maximal tumor SUV was 6.1 (range, 2.4-∼19.2). Patients with low maximal tumor SUVs (<6.1) had a higher disease control rate than those with high maximal tumor SUVs (≥6.1) (86.8{\%} vs 68.5{\%}, respectively, P =.023). Both median progression-free survival (PFS; 8.4 vs 5.2 months; P =.003) and overall survival (OS; 17.9 vs 11.3 months; P =.013) were significantly longer in the low maximal tumor SUV group than in the high maximal tumor SUV group, respectively. In multivariate analysis, low maximal tumor SUV and objective responses to CCRT remained significant for PFS and OS. The high maximal tumor SUV group was more likely to have extrahepatic metastasis within 6 months than the low maximal tumor SUV group (58.1{\%} vs 26.8{\%}, respectively; P <.001). Similar results were obtained for the maximal tumor SUV/normal liver maximal SUV ratio (<2 vs ≥2) concerning progression, death, and extrahepatic metastasis. CONCLUSIONS: Metabolic activity may be useful not only in predicting prognosis and treatment responses, but also in establishing optimal treatment plans in locally advanced HCC. Cancer 2011;.",
author = "Kim, {Beom Kyung} and Kang, {Won Jun} and Kim, {Ja Kyung} and Jinsil Seong and Junyong Park and doyoung kim and SangHoon Ahn and Lee, {Do Youn} and Lee, {Kwang Hoon} and Lee, {Jong Doo} and KwangHyub Han",
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18F-fluorodeoxyglucose uptake on positron emission tomography as a prognostic predictor in locally advanced hepatocellular carcinoma. / Kim, Beom Kyung; Kang, Won Jun; Kim, Ja Kyung; Seong, Jinsil; Park, Junyong; kim, doyoung; Ahn, SangHoon; Lee, Do Youn; Lee, Kwang Hoon; Lee, Jong Doo; Han, KwangHyub.

In: Cancer, Vol. 117, No. 20, 15.10.2011, p. 4779-4787.

Research output: Contribution to journalArticle

TY - JOUR

T1 - 18F-fluorodeoxyglucose uptake on positron emission tomography as a prognostic predictor in locally advanced hepatocellular carcinoma

AU - Kim, Beom Kyung

AU - Kang, Won Jun

AU - Kim, Ja Kyung

AU - Seong, Jinsil

AU - Park, Junyong

AU - kim, doyoung

AU - Ahn, SangHoon

AU - Lee, Do Youn

AU - Lee, Kwang Hoon

AU - Lee, Jong Doo

AU - Han, KwangHyub

PY - 2011/10/15

Y1 - 2011/10/15

N2 - BACKGROUND: Metabolic activity assessed by 18F- fluorodeoxyglocuse-positron emission tomography (18F-FDG-PET) reflects biological aggressiveness and prognoses in various tumors. The authors present a correlation between tumor metabolic activity and clinical outcomes in patients with hepatocellular carcinoma (HCC). METHODS: Over a 3-year period (2005-2008), 135 locally advanced HCC patients were treated with localized concurrent chemoradiotherapy (CCRT; external beam radiotherapy at 45 grays for 5 weeks plus concurrent hepatic arterial infusion of 5-fluorouracil during the first and fifth week) followed by repetitive hepatic arterial infusional chemotherapy with 5-fluorouracil and cisplatin. Among them, the authors studied 107 who received 18F-FDG-PET before CCRT. Maximal standardized uptake values (SUVs) of tumors were calculated. RESULTS: The median maximal tumor SUV was 6.1 (range, 2.4-∼19.2). Patients with low maximal tumor SUVs (<6.1) had a higher disease control rate than those with high maximal tumor SUVs (≥6.1) (86.8% vs 68.5%, respectively, P =.023). Both median progression-free survival (PFS; 8.4 vs 5.2 months; P =.003) and overall survival (OS; 17.9 vs 11.3 months; P =.013) were significantly longer in the low maximal tumor SUV group than in the high maximal tumor SUV group, respectively. In multivariate analysis, low maximal tumor SUV and objective responses to CCRT remained significant for PFS and OS. The high maximal tumor SUV group was more likely to have extrahepatic metastasis within 6 months than the low maximal tumor SUV group (58.1% vs 26.8%, respectively; P <.001). Similar results were obtained for the maximal tumor SUV/normal liver maximal SUV ratio (<2 vs ≥2) concerning progression, death, and extrahepatic metastasis. CONCLUSIONS: Metabolic activity may be useful not only in predicting prognosis and treatment responses, but also in establishing optimal treatment plans in locally advanced HCC. Cancer 2011;.

AB - BACKGROUND: Metabolic activity assessed by 18F- fluorodeoxyglocuse-positron emission tomography (18F-FDG-PET) reflects biological aggressiveness and prognoses in various tumors. The authors present a correlation between tumor metabolic activity and clinical outcomes in patients with hepatocellular carcinoma (HCC). METHODS: Over a 3-year period (2005-2008), 135 locally advanced HCC patients were treated with localized concurrent chemoradiotherapy (CCRT; external beam radiotherapy at 45 grays for 5 weeks plus concurrent hepatic arterial infusion of 5-fluorouracil during the first and fifth week) followed by repetitive hepatic arterial infusional chemotherapy with 5-fluorouracil and cisplatin. Among them, the authors studied 107 who received 18F-FDG-PET before CCRT. Maximal standardized uptake values (SUVs) of tumors were calculated. RESULTS: The median maximal tumor SUV was 6.1 (range, 2.4-∼19.2). Patients with low maximal tumor SUVs (<6.1) had a higher disease control rate than those with high maximal tumor SUVs (≥6.1) (86.8% vs 68.5%, respectively, P =.023). Both median progression-free survival (PFS; 8.4 vs 5.2 months; P =.003) and overall survival (OS; 17.9 vs 11.3 months; P =.013) were significantly longer in the low maximal tumor SUV group than in the high maximal tumor SUV group, respectively. In multivariate analysis, low maximal tumor SUV and objective responses to CCRT remained significant for PFS and OS. The high maximal tumor SUV group was more likely to have extrahepatic metastasis within 6 months than the low maximal tumor SUV group (58.1% vs 26.8%, respectively; P <.001). Similar results were obtained for the maximal tumor SUV/normal liver maximal SUV ratio (<2 vs ≥2) concerning progression, death, and extrahepatic metastasis. CONCLUSIONS: Metabolic activity may be useful not only in predicting prognosis and treatment responses, but also in establishing optimal treatment plans in locally advanced HCC. Cancer 2011;.

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