Preoperative nodal 18F-FDG avidity rather than primary tumor avidity determines the prognosis of patients with advanced gastric cancer

Hyun Woo Kwon, Liang An, Hye Ryeong Kwon, Sungsoo Park, Sungeun Kim

Research output: Contribution to journalArticle

Abstract

Purpose: This study investigated whether the metabolic avidity of primary tumors and/ or metastatic lymph nodes (LNs) measured by 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) was related to survival after surgery in patients with advanced gastric cancer (AGC). Materials and Methods: One hundred sixty-eight patients with AGC who underwent preoperative 18F-FDG PET/CT and curative resection were included. The 18F-FDG avidity of the primary gastric tumor and LNs was determined quantitatively and qualitatively. The diagnostic performance of 18F-FDG PET/CT was calculated, and the prognostic significance of 18F-FDG avidity for recurrence-free survival (RFS) and overall survival (OS) was assessed. Results: In all, 51 (30.4%) patients experienced recurrence, and 32 (19.0%) died during follow-up (median follow-up duration, 35 months; range, 3–81 months); 119 (70.8%) and 33 (19.6%) patients showed 18F-FDG-avid primary tumors and LNs, respectively. 18F-FDG PET/ CT showed high sensitivity (73.8%) for the detection of advanced pathologic T (pT ≥3) stage and high specificity (92.2%) for the detection of advanced pN (≥2) stage. 18F-FDG avidity of LNs was significantly associated with RFS (P=0.012), whereas that of primary tumors did not show significance (P=0.532). Univariate and multivariate analyses revealed that 18F-FDG avidity of LNs was an independent prognostic factor for RFS (hazard ratio=2.068; P=0.029). Conclusions: 18F-FDG avidity of LNs is an independent prognostic factor for predicting RFS. Preoperative 18F-FDG PET/CT can be used to determine the risk and prognosis of patients with AGC after curative resection.

Original languageEnglish
Pages (from-to)218-229
Number of pages12
JournalJournal of Gastric Cancer
Volume18
Issue number3
DOIs
Publication statusPublished - 2018 Sep 1

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Fluorodeoxyglucose F18
Stomach Neoplasms
Neoplasms
Lymph Nodes
Survival
Recurrence
Stomach
Multivariate Analysis

Keywords

  • F-fluorodeoxyglucose
  • Gastric cancer
  • Positron emission tomography computed tomography
  • Recurrence

ASJC Scopus subject areas

  • Oncology
  • Gastroenterology
  • Cancer Research

Cite this

Preoperative nodal 18F-FDG avidity rather than primary tumor avidity determines the prognosis of patients with advanced gastric cancer. / Kwon, Hyun Woo; An, Liang; Kwon, Hye Ryeong; Park, Sungsoo; Kim, Sungeun.

In: Journal of Gastric Cancer, Vol. 18, No. 3, 01.09.2018, p. 218-229.

Research output: Contribution to journalArticle

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abstract = "Purpose: This study investigated whether the metabolic avidity of primary tumors and/ or metastatic lymph nodes (LNs) measured by 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) was related to survival after surgery in patients with advanced gastric cancer (AGC). Materials and Methods: One hundred sixty-eight patients with AGC who underwent preoperative 18F-FDG PET/CT and curative resection were included. The 18F-FDG avidity of the primary gastric tumor and LNs was determined quantitatively and qualitatively. The diagnostic performance of 18F-FDG PET/CT was calculated, and the prognostic significance of 18F-FDG avidity for recurrence-free survival (RFS) and overall survival (OS) was assessed. Results: In all, 51 (30.4{\%}) patients experienced recurrence, and 32 (19.0{\%}) died during follow-up (median follow-up duration, 35 months; range, 3–81 months); 119 (70.8{\%}) and 33 (19.6{\%}) patients showed 18F-FDG-avid primary tumors and LNs, respectively. 18F-FDG PET/ CT showed high sensitivity (73.8{\%}) for the detection of advanced pathologic T (pT ≥3) stage and high specificity (92.2{\%}) for the detection of advanced pN (≥2) stage. 18F-FDG avidity of LNs was significantly associated with RFS (P=0.012), whereas that of primary tumors did not show significance (P=0.532). Univariate and multivariate analyses revealed that 18F-FDG avidity of LNs was an independent prognostic factor for RFS (hazard ratio=2.068; P=0.029). Conclusions: 18F-FDG avidity of LNs is an independent prognostic factor for predicting RFS. Preoperative 18F-FDG PET/CT can be used to determine the risk and prognosis of patients with AGC after curative resection.",
keywords = "F-fluorodeoxyglucose, Gastric cancer, Positron emission tomography computed tomography, Recurrence",
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T1 - Preoperative nodal 18F-FDG avidity rather than primary tumor avidity determines the prognosis of patients with advanced gastric cancer

AU - Kwon, Hyun Woo

AU - An, Liang

AU - Kwon, Hye Ryeong

AU - Park, Sungsoo

AU - Kim, Sungeun

PY - 2018/9/1

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N2 - Purpose: This study investigated whether the metabolic avidity of primary tumors and/ or metastatic lymph nodes (LNs) measured by 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) was related to survival after surgery in patients with advanced gastric cancer (AGC). Materials and Methods: One hundred sixty-eight patients with AGC who underwent preoperative 18F-FDG PET/CT and curative resection were included. The 18F-FDG avidity of the primary gastric tumor and LNs was determined quantitatively and qualitatively. The diagnostic performance of 18F-FDG PET/CT was calculated, and the prognostic significance of 18F-FDG avidity for recurrence-free survival (RFS) and overall survival (OS) was assessed. Results: In all, 51 (30.4%) patients experienced recurrence, and 32 (19.0%) died during follow-up (median follow-up duration, 35 months; range, 3–81 months); 119 (70.8%) and 33 (19.6%) patients showed 18F-FDG-avid primary tumors and LNs, respectively. 18F-FDG PET/ CT showed high sensitivity (73.8%) for the detection of advanced pathologic T (pT ≥3) stage and high specificity (92.2%) for the detection of advanced pN (≥2) stage. 18F-FDG avidity of LNs was significantly associated with RFS (P=0.012), whereas that of primary tumors did not show significance (P=0.532). Univariate and multivariate analyses revealed that 18F-FDG avidity of LNs was an independent prognostic factor for RFS (hazard ratio=2.068; P=0.029). Conclusions: 18F-FDG avidity of LNs is an independent prognostic factor for predicting RFS. Preoperative 18F-FDG PET/CT can be used to determine the risk and prognosis of patients with AGC after curative resection.

AB - Purpose: This study investigated whether the metabolic avidity of primary tumors and/ or metastatic lymph nodes (LNs) measured by 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) was related to survival after surgery in patients with advanced gastric cancer (AGC). Materials and Methods: One hundred sixty-eight patients with AGC who underwent preoperative 18F-FDG PET/CT and curative resection were included. The 18F-FDG avidity of the primary gastric tumor and LNs was determined quantitatively and qualitatively. The diagnostic performance of 18F-FDG PET/CT was calculated, and the prognostic significance of 18F-FDG avidity for recurrence-free survival (RFS) and overall survival (OS) was assessed. Results: In all, 51 (30.4%) patients experienced recurrence, and 32 (19.0%) died during follow-up (median follow-up duration, 35 months; range, 3–81 months); 119 (70.8%) and 33 (19.6%) patients showed 18F-FDG-avid primary tumors and LNs, respectively. 18F-FDG PET/ CT showed high sensitivity (73.8%) for the detection of advanced pathologic T (pT ≥3) stage and high specificity (92.2%) for the detection of advanced pN (≥2) stage. 18F-FDG avidity of LNs was significantly associated with RFS (P=0.012), whereas that of primary tumors did not show significance (P=0.532). Univariate and multivariate analyses revealed that 18F-FDG avidity of LNs was an independent prognostic factor for RFS (hazard ratio=2.068; P=0.029). Conclusions: 18F-FDG avidity of LNs is an independent prognostic factor for predicting RFS. Preoperative 18F-FDG PET/CT can be used to determine the risk and prognosis of patients with AGC after curative resection.

KW - F-fluorodeoxyglucose

KW - Gastric cancer

KW - Positron emission tomography computed tomography

KW - Recurrence

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