Zattoni Fabio, Incerti Elena, Dal Moro Fabrizio, Moschini Marco, Castellucci Paolo, Panareo Stefano, Picchio Maria, Fallanca Federico, Briganti Alberto, Gallina Andrea, Fanti Stefano, Schiavina Riccardo, Brunocilla Eugenio, Rambaldi Ilaria, Lowe Val, Karnes Jeffrey R, Evangelista Laura
Department of Surgery, Oncology and Gastroenterology, University of Padua, 35128 Padua, Italy.
Urology Unit, Academical Medical Centre Hospital, 33100 Udine, Italy.
Cancers (Basel). 2019 May 20;11(5):700. doi: 10.3390/cancers11050700.
: To evaluate the ability of F-labeled fluoro-2-deoxyglucose positron emission tomography/computed tomography (F-FDG PET/CT) to predict survivorship of patients with bladder cancer (BC) and/or upper urinary tract carcinoma (UUTC). : Data from patients who underwent FDG PET/CT for suspicion of recurrent urothelial carcinoma (UC) between 2007 and 2015 were retrospectively collected in a multicenter study. Disease management after the introduction of FDG PET/CT in the diagnostic algorithm was assessed in all patients. Kaplan-Meier and log-rank analysis were computed for survival assessment. A Cox regression analysis was used to identify predictors of recurrence and death, for BC, UUTC, and concomitant BC and UUTC. : Data from 286 patients were collected. Of these, 212 had a history of BC, 38 of UUTC and 36 of concomitant BC and UUTC. Patient management was changed in 114/286 (40%) UC patients with the inclusion of FDG PET/CT, particularly in those with BC, reaching 74% ( = 90/122). After a mean follow-up period of 21 months (Interquartile range: 4-28 mo.), 136 patients (47.4%) had recurrence/progression of disease. Moreover, 131 subjects (45.6%) died. At Kaplan-Meier analyses, patients with BC and positive PET/CT had a worse overall survival than those with a negative scan (log-rank < 0.001). Furthermore, a negative PET/CT scan was associated with a lower recurrence rate than a positive examination, independently from the primary tumor site. At multivariate analysis, in patients with BC and UUTC, a positive FDG PET/CT resulted an independent predictor of disease-free and overall survival ( < 0,01). : FDG PET/CT has the potential to change patient management, particularly for patients with BC. Furthermore, it can be considered a valid survival prediction tool after primary treatment in patients with recurrent UC. However, a firm recommendation cannot be made yet. Further prospective studies are necessary to confirm our findings.
评估F标记的氟代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）预测膀胱癌（BC）和/或上尿路癌（UUTC）患者生存率的能力。：在一项多中心研究中，回顾性收集了2007年至2015年间因怀疑复发性尿路上皮癌（UC）而接受FDG PET/CT检查的患者数据。评估了所有患者在诊断算法中引入FDG PET/CT后的疾病管理情况。采用Kaplan-Meier法和对数秩检验进行生存评估。使用Cox回归分析确定BC、UUTC以及合并BC和UUTC患者复发和死亡的预测因素。：收集了286例患者的数据。其中，212例有BC病史，38例有UUTC病史，36例有BC和UUTC合并病史。114/286（40%）例UC患者的治疗方案因纳入FDG PET/CT而改变，尤其是BC患者，比例达到74%（n = 90/122）。平均随访21个月（四分位间距：4 - 28个月）后，136例患者（47.4%）出现疾病复发/进展。此外，131例患者（45.6%）死亡。在Kaplan-Meier分析中，PET/CT阳性的BC患者总生存率低于扫描阴性的患者（对数秩检验P < 0.001）。此外，与阳性检查相比，PET/CT扫描阴性与较低的复发率相关，且与原发肿瘤部位无关。多因素分析显示，在BC和UUTC患者中，FDG PET/CT阳性是无病生存和总生存的独立预测因素（P < 0.01）。：FDG PET/CT有可能改变患者的治疗方案，尤其是BC患者。此外，对于复发性UC患者，它可被视为初次治疗后有效的生存预测工具。然而，目前尚不能给出确切推荐。需要进一步的前瞻性研究来证实我们的发现。
