Center for Liver Cancer, National Cancer Center, Goyang-si, Gyeonggi-do, Republic of Korea.
Center for Liver Cancer, National Cancer Center, Goyang-si, Gyeonggi-do, Republic of Korea.
Eur J Surg Oncol. 2018 May;44(5):670-676. doi: 10.1016/j.ejso.2018.01.243. Epub 2018 Feb 6.
Colorectal cancer liver metastasis (CRLM) can be cured with surgery. To improve survival, optimal selection of CRLM patients should be done cautiously, which may be facilitated by preoperative [F-18] fluorodeoxyglucose positron emission tomography/computed tomography (F-FDG PET/CT).
A total of 245 patients with CRLM between February 2007 and January 2015 were retrospectively studied. All clinical variables, pathological data, and various PET/CT parameters were correlated with disease-free survival (DFS) and overall survival (OS). Metastatic tumor maximum standardized uptake value (SUV) and normal liver mean SUV (SUV) ratio was selected for group classification.
The median DFS in months were 24.5 months and median OS were 41.7 months. Multivariate analysis found an increased risk of worse prognosis in DFS for primary colon cancer T3∼T4, N2 stage, neoadjuvant chemotherapy, synchronous metastasis, multiple metastatic tumor number and metastatic tumor SUV/normal liver SUV ratio >4.3. The DFS rate of each group classified by SUV ratio was 58.1%, 39.0%, and 33.6% vs. 39.3%, 20.8%, and 15.8% at 1, 3, and 5 years (p = 0.017). Patients with multiple tumors and SUV ratio of >4.3 showed worst survival (OS rate: 74.2%, 41.5%, and 24.2%, p = 0.001 at 1, 3, and 5 years, respectively).
PET/CT variables can be a valuable prognostic factor in patients with CRLM for the prediction of recurrence. Preoperative PET/CT may improve risk stratification and optimize outcomes of patients with CRLM.
结直肠癌肝转移（CRLM）可以通过手术治愈。为了提高生存率，应谨慎选择 CRLM 患者，术前 [F-18]氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（F-FDG PET/CT）有助于实现这一目标。
回顾性分析 2007 年 2 月至 2015 年 1 月期间 245 例 CRLM 患者。将所有临床变量、病理数据和各种 PET/CT 参数与无病生存（DFS）和总生存（OS）相关联。选择转移瘤最大标准化摄取值（SUV）与正常肝平均 SUV（SUV）比值作为分组依据。
中位 DFS 为 24.5 个月，中位 OS 为 41.7 个月。多因素分析发现，DFS 预后不良的风险增加与原发结肠癌 T3∼T4、N2 期、新辅助化疗、同步转移、多个转移瘤数量和转移瘤 SUV/正常肝 SUV 比值＞4.3 相关。SUV 比值分组后各亚组的 DFS 率分别为 58.1%、39.0%和 33.6%与 39.3%、20.8%和 15.8%在 1、3 和 5 年（p=0.017）。多发肿瘤和 SUV 比值＞4.3 的患者生存最差（OS 率：1 年、3 年和 5 年分别为 74.2%、41.5%和 24.2%，p=0.001）。
PET/CT 变量可作为 CRLM 患者预测复发的有价值的预后因素。术前 PET/CT 可能改善 CRLM 患者的风险分层并优化其预后。
