Preoperative Nodal 18F-FDG Avidity Rather than Primary Tumor Avidity Determines the Prognosis of Patients with Advanced Gastric Cancer

권현우; Liang An; 권혜령; 박성수; 김성은

doi:https://doi.org/10.5230/jgc.2018.18.e23

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자료유형: 학술저널

저자정보: 권현우 (고려대학교) Liang An (고려대학교) 권혜령 (고려대학교) 박성수 (고려대학교) 김성은 (고려대학교)

저널정보: 대한위암학회 Journal of Gastric Cancer Journal of Gastric Cancer 제18권 제3호

발행연도: 2018.9

수록면: 218 - 229 (12page)

DOI: https://doi.org/10.5230/jgc.2018.18.e23

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Purpose: This study investigated whether the metabolic avidity of primary tumors and/or metastatic lymph nodes (LNs) measured by 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) was related to survival after surgery in patients with advanced gastric cancer (AGC). Materials and Methods: One hundred sixty-eight patients with AGC who underwent preoperative 18F-FDG PET/CT and curative resection were included. The 18F-FDG avidity of the primary gastric tumor and LNs was determined quantitatively and qualitatively. The diagnostic performance of 18F-FDG PET/CT was calculated, and the prognostic significance of 18F-FDG avidity for recurrence-free survival (RFS) and overall survival (OS) was assessed. Results: In all, 51 (30.4%) patients experienced recurrence, and 32 (19.0%) died during follow-up (median follow-up duration, 35 months; range, 3?81 months); 119 (70.8%) and 33 (19.6%) patients showed 18F-FDG-avid primary tumors and LNs, respectively. 18F-FDG PET/CT showed high sensitivity (73.8%) for the detection of advanced pathologic T (pT ≥3) stage and high specificity (92.2%) for the detection of advanced pN (≥2) stage. 18F-FDG avidity of LNs was significantly associated with RFS (P=0.012), whereas that of primary tumors did not show significance (P=0.532). Univariate and multivariate analyses revealed that 18F-FDG avidity of LNs was an independent prognostic factor for RFS (hazard ratio=2.068; P=0.029). Conclusions: 18F-FDG avidity of LNs is an independent prognostic factor for predicting RFS. Preoperative 18F-FDG PET/CT can be used to determine the risk and prognosis of patients with AGC after curative resection.

#Gastric cancer #18F-fluorodeoxyglucose #Positron Emission Tomography Computed Tomography #Recurrence

참고문헌 (37)

참고문헌 신청

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