Nuclear Medicine Department, Oncology Centre, Bydgoszcz, Poland.
Department of Positron Emission Tomography and Molecular Diagnostic, Nicolaus Copernicus University, Collegium Medicum, Bydgoszcz, Poland.
Clin Exp Med. 2019 Feb;19(1):143-148. doi: 10.1007/s10238-018-0539-9. Epub 2018 Nov 28.
Accurate prediction of the outcome of molecular target-based treatment in advanced renal cell carcinoma (RCC) is an important clinical problem. Positron emission tomography/computed tomography using [18F]-2-fluoro-2-deoxyglucose (FDG PET/CT) is a noninvasive tool for the assessment of glucose accumulation which can be a marker of the biological characteristics of the tumor. In this paper, we assess FDG PET/CT as a survival prognostic marker in patients with advanced RCC. The study included 121 patients treated in the years 2011-2016 with a diagnosis of advanced renal cell carcinoma (stage IV, multifocal metastases in all patients). Assessment using FDG PET/CT was conducted by measuring the maximum standard uptake value (SUVmax) for the marker used (the highest SUV measurement result for each patient in a single examination). SUVmax measurements were compared with various clinical risk factors used as prognostic markers. The median follow-up period was 19 months (ranging from 3 to 61 months). SUVmax measurements in all patients ranged from 1.3 to 30.0 (median 6.9). Higher SUVmax was correlated with poorer prognosis. Multi-way analysis with standard risk factors revealed that SUVmax was an independent factor for overall survival (OS; p < 0.003, hazard ratio 1.312, 95% CI 1.147-1.346). For SUVmax < 7.0, median OS was 32 months. For 7.0 ≤ SUVmax < 12.0, median OS was 12.5 months. For SUVmax ≥ 12.0, median OS was 10 months. The differences were statistically significant. A preliminary SUVmax assessment conducted using FDG PET/CT can provide information useful in the prediction of survival of patients with advanced RCC.
准确预测晚期肾细胞癌（RCC）中基于分子靶向治疗的结局是一个重要的临床问题。正电子发射断层扫描/计算机断层扫描（PET/CT）使用[18F]-2-氟-2-脱氧葡萄糖（FDG）评估葡萄糖摄取，这是一种非侵入性工具，可作为肿瘤生物学特征的标志物。在本文中，我们评估 FDG PET/CT 作为晚期 RCC 患者的生存预后标志物。该研究纳入了 2011 年至 2016 年期间诊断为晚期肾细胞癌（IV 期，所有患者均有多发性转移）的 121 名患者。使用 FDG PET/CT 进行评估是通过测量用于标记物的最大标准摄取值（SUVmax）（每个患者单次检查中 SUV 测量结果的最高值）进行的。SUVmax 测量结果与用作预后标志物的各种临床危险因素进行了比较。中位随访时间为 19 个月（范围为 3 至 61 个月）。所有患者的 SUVmax 测量值范围为 1.3 至 30.0（中位数为 6.9）。SUVmax 值越高，预后越差。标准风险因素的多因素分析表明，SUVmax 是总生存（OS）的独立因素（p<0.003，风险比 1.312，95%CI 1.147-1.346）。对于 SUVmax<7.0，中位 OS 为 32 个月。对于 7.0≤SUVmax<12.0，中位 OS 为 12.5 个月。对于 SUVmax≥12.0，中位 OS 为 10 个月。这些差异具有统计学意义。使用 FDG PET/CT 进行初步 SUVmax 评估可提供有助于预测晚期 RCC 患者生存的信息。
