Tsuneki Takao, Matsuda Takeru, Sawada Ryuichiro, Hasegawa Hiroshi, Yamashita Kimihiro, Koterazawa Yasufumi, Harada Hitoshi, Urakawa Naoki, Goto Hironobu, Kanaji Shingo, Kakeji Yoshihiro
Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
Division of Minimally Invasive Surgery, Department of Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-Chou, Chuo-Ku, Kobe, 650-0017, Japan.
Surg Today. 2025 Feb;55(2):154-161. doi: 10.1007/s00595-024-02880-4. Epub 2024 Jun 15.
The association between the reduction rate of the maximum standardized uptake value (SUVmax) on positron emission tomography (PET) during neoadjuvant chemoradiotherapy (NACRT) and the prognosis in patients with locally advanced rectal cancer is unknown.
We retrospectively analyzed 62 patients with locally advanced rectal cancer who underwent curative surgery after NACRT at Kobe University between 2008 and 2021. The SUVmax reduction rate was calculated from preoperative and postoperative PET scans, and its association with the prognosis was investigated.
The cutoff value for SUVmax reduction rate was 61.5%. Twenty patients had an SUVmax reduction rate > 61.5% (SUV responder group) and 38 patients had an SUVmax reduction rate ≤ 61.5% (SUV nonresponder group). Regarding pathological outcomes, the rate of a good histological response was significantly higher in the SUV responder group than in the SUV nonresponder group (80.0% vs. 21.1%, p < 0.001). Both the overall (OS) and relapse-free survival (RFS) rates were significantly better in the SUV responder group than in the SUV nonresponder group (OS, p = 0.035; RFS, p = 0.019). In the SUV responder group, only 1 case of recurrence was observed, with a median follow-up period of 56 months.
The rate of SUVmax reduction during NACRT might predict the long-term prognosis of patients with locally advanced rectal cancer.
新辅助放化疗(NACRT)期间,正电子发射断层扫描(PET)中最大标准化摄取值(SUVmax)的降低率与局部晚期直肠癌患者预后之间的关系尚不清楚。
我们回顾性分析了2008年至2021年期间在神户大学接受NACRT后行根治性手术的62例局部晚期直肠癌患者。根据术前和术后PET扫描计算SUVmax降低率,并研究其与预后的关系。
SUVmax降低率的临界值为61.5%。20例患者的SUVmax降低率>61.5%(SUV反应组),38例患者的SUVmax降低率≤61.5%(SUV无反应组)。在病理结果方面,SUV反应组的良好组织学反应率显著高于SUV无反应组(80.0%对21.1%,p<0.001)。SUV反应组的总生存率(OS)和无复发生存率(RFS)均显著优于SUV无反应组(OS,p=0.035;RFS,p=0.019)。在SUV反应组中,中位随访期为56个月,仅观察到1例复发。
NACRT期间SUVmax的降低率可能预测局部晚期直肠癌患者的长期预后。