Hwang Sang Hyun, Jung Minkyu, Jeong Yong Hyu, Jo KwanHyeong, Kim Soyoung, Wang Jiyoung, Cho Arthur
Department of Nuclear Medicine, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Republic of Korea.
Cancer Metab. 2021 Jan 28;9(1):8. doi: 10.1186/s40170-021-00244-x.
This study aimed to evaluate the prognostic value of pretreatment F-fluorodeoxyglucose positron emission tomography/computed tomography (F-FDG PET/CT) in patients with localized primary gastrointestinal stromal tumors (GISTs) and to compare the predictive values of F-FDG PET/CT parameters with those of clinicopathological prognostic factors.
Sixty-two localized GIST patients who underwent staging with F-FDG PET/CT from January 2007 to December 2013 before surgery were retrospectively enrolled. A volume of interest with a standardized uptake value (SUV) threshold of 2.5 was used to determine the metabolic tumor volume (MTV) and total lesion glycolysis (TLG). These metabolic indices, along with the maximum SUV (SUVmax), were analyzed to evaluate recurrence-free survival (RFS). Other significant clinical and pathologic indices were also retrospectively reviewed for RFS analysis.
Patients were followed up for a median of 42.0 months (range, 5.6-111.5). During the follow-up period, 13 patients (21.0%) experienced disease recurrence. In univariate analysis, tumor size (> 5 cm), mitotic count (> 5/high-power field), modified National Institutes of Health (NIH) consensus criteria, adjuvant imatinib treatment, SUVmax (≥ 7.04), MTV (≥ 50.76 cm), and TLG (≥ 228.79 g) were significant prognostic factors affecting RFS (p < 0.05). In multivariate analysis, only MTV (hazard ratio, 17.69; 95% confidence interval [CI], 2.03-154.17, p = 0.009) and TLG (hazard ratio, 20.48; 95% CI, 2.19-191.16, p = 0.008) were independent prognostic factors for RFS. The 5-year RFS rates were 96.4% and 96.6% in patients with a low MTV and TLG and 27.3% and 23.6% in patients with a high MTV and TLG, respectively (p < 0.001).
MTV and TLG are independent prognostic factors for predicting recurrence in patients with localized primary GIST. Patients with a high MTV or TLG are at risk for poor prognosis and should be closely observed for disease recurrence.
本研究旨在评估治疗前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）对局限性原发性胃肠道间质瘤（GIST）患者的预后价值，并比较F-FDG PET/CT参数与临床病理预后因素的预测价值。
回顾性纳入2007年1月至2013年12月期间62例术前接受F-FDG PET/CT分期的局限性GIST患者。使用标准化摄取值（SUV）阈值为2.5的感兴趣体积来确定代谢肿瘤体积（MTV）和总病变糖酵解（TLG）。分析这些代谢指标以及最大SUV（SUVmax）以评估无复发生存期（RFS）。还回顾性分析了其他重要的临床和病理指标以进行RFS分析。
患者的中位随访时间为42.0个月（范围5.6 - 111.5个月）。在随访期间，13例患者（21.0%）出现疾病复发。单因素分析中，肿瘤大小（>5 cm）、有丝分裂计数（>5/高倍视野）、改良的美国国立卫生研究院（NIH）共识标准、辅助伊马替尼治疗、SUVmax（≥7.04）、MTV（≥50.76 cm）和TLG（≥228.79 g）是影响RFS的显著预后因素（p<0.05）。多因素分析中，只有MTV（风险比，17.69；95%置信区间[CI]，2.03 - 154.17，p = 0.009）和TLG（风险比，20.48；95%CI，2.19 - 191.16，p = 0.008）是RFS的独立预后因素。MTV和TLG较低的患者5年RFS率分别为96.4%和96.6%，MTV和TLG较高的患者分别为27.3%和23.6%（p<0.001）。
MTV和TLG是预测局限性原发性GIST患者复发的独立预后因素。MTV或TLG较高的患者预后较差，应密切观察疾病复发情况。
Zotero 插件
