Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehagro, Chongno-gu, Seoul 110-744, Korea.
Cancer Chemother Pharmacol. 2011 Jul;68(1):165-75. doi: 10.1007/s00280-010-1454-2. Epub 2010 Sep 25.
The role of (18)F FDG-PET in hepatocellular carcinoma (HCC) has not been firmly established. We conducted this study to investigate the clinical implication of SUVmax on (18)F FDG-PET as a prognostic factor in patients with HCC, especially in the metastatic setting.
HCC patients with extrahepatic metastatic lesions were enrolled that were evaluated by (18)F FDG-PET before palliative systemic therapy, between January 2002 and December 2009 at the Seoul National University Hospital. We retrospectively analyzed the clinical outcome and the value of the SUVmax.
A total of 25 patients (men, 88.0%) were enrolled. The response rate and disease control rate was 18.2% (95% CI: 2.1-34.3) and 32.0% (95% CI: 16.3-56.5), respectively. The progression-free survival (PFS) and overall survival (OS) were 2.3 months (95% CI: 1.1-3.4) and 14.2 months (95% CI: 9.1-19.2), respectively. The univariate analysis of OS showed that SUVmax and alphafetoprotein (AFP) were significant prognostic factors (P = 0.023 and P = 0.006, respectively). The multivariate analysis of OS showed that SUVmax and AFP were significant prognostic factors (P = 0.008 and P = 0.006, respectively). SUVmax and AFP were independent prognostic factors for PFS, too (P = 0.010 and P = 0.016, respectively). When the patients were divided according to the SUVmax and AFP, the patients with an SUVmax < 4.9 and an AFP ≤ 400 ng/ml showed longer OS and PFS than the patients with SUVmax ≥ 4.9 or AFP > 400 ng/ml (26.7 months vs. 9.3 months, P < 0.001 and 5.6 months vs. 1.7 months, P = 0.012, respectively).
The SUVmax of the (18)F FDG-PET has a prognostic value for OS and PFS in patients with metastatic HCC undergoing systemic therapy. The combined analysis of the SUVmax with AFP might provide more detailed prognostic information.
（18）F FDG-PET 在肝细胞癌（HCC）中的作用尚未得到明确确立。我们进行了这项研究，旨在探讨 SUVmax 在接受姑息性全身治疗前的 HCC 患者（尤其是转移性 HCC 患者）中作为预后因素的临床意义。
回顾性分析了 2002 年 1 月至 2009 年 12 月期间在首尔国立大学医院接受（18）F FDG-PET 检查并伴有肝外转移病灶的 HCC 患者的临床结局和 SUVmax 的价值。
共纳入 25 例患者（男性占 88.0%）。客观缓解率和疾病控制率分别为 18.2%（95%CI：2.1-34.3）和 32.0%（95%CI：16.3-56.5）。无进展生存期（PFS）和总生存期（OS）分别为 2.3 个月（95%CI：1.1-3.4）和 14.2 个月（95%CI：9.1-19.2）。OS 的单因素分析显示，SUVmax 和甲胎蛋白（AFP）是显著的预后因素（P=0.023 和 P=0.006）。OS 的多因素分析显示，SUVmax 和 AFP 也是显著的预后因素（P=0.008 和 P=0.006）。SUVmax 和 AFP 也是 PFS 的独立预后因素（P=0.010 和 P=0.016）。当根据 SUVmax 和 AFP 将患者进行分组时，SUVmax＜4.9 和 AFP≤400ng/ml 的患者的 OS 和 PFS 长于 SUVmax≥4.9 或 AFP＞400ng/ml 的患者（26.7 个月 vs. 9.3 个月，P＜0.001 和 5.6 个月 vs. 1.7 个月，P=0.012）。
在接受全身治疗的转移性 HCC 患者中，（18）F FDG-PET 的 SUVmax 对 OS 和 PFS 具有预后价值。SUVmax 与 AFP 的联合分析可能提供更详细的预后信息。
