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Prognostic value of 18F-fluorodeoxyglucose positron emission tomography/computed tomography in patients with Barcelona Clinic Liver Cancer stages 0 and A hepatocellular carcinomas: a multicenter retrospective cohort study

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Author(s)
Kyung-Han LeeJoon Young ChoiSae Jung NaIl Ki HongJin Kyoung OhYong An ChungBong-Il SongTae-Sung KimKyung Sik KimSeung Hyup HyunJae Seon EoJeong Won LeeDae Hyuk MoonMijin Yun
Keimyung Author(s)
Song, Bong Il
Department
Dept. of Nuclear Medicine (핵의학)
Journal Title
European Journal of Nuclear Medicine and Molecular Imaging
Issued Date
2016
Volume
43
Issue
9
Keyword
FDG PET/CTHepatocellular carcinomaStandardized uptake valuePrognosisMulticenter trial
Abstract
Purpose

We evaluated the prognostic value of pretreatment 18F-fluorodeoxyglucose positron emission tomography with computed tomography (FDG PET/CT) in patients with Barcelona Clinic Liver Cancer (BCLC) stage 0 or A hepatocellular carcinoma (HCC) who had received curative treatment or transarterial chemoembolization (TACE).


Methods

Between 2009 and 2010, 317 patients diagnosed with HCC at seven hospitals were enrolled. Among these, 195 patients underwent curative treatments including resection, liver transplantation, and radiofrequency ablation. TACE was performed in 122 patients. The tumor-to-normal liver standardized uptake value ratio (TLR) of the primary tumor was measured using pretreatment FDG PET/CT. The prognostic significance of TLR and other clinical variables was assessed using Cox regression models. Differences in the overall survival (OS) associated with TLR or other significant clinical factors were examined using the Kaplan-Meier method.


Results

Over a median follow-up period of 46 months, 77 patients died from cancer. In the curative cohort, higher TLR (≥2) was significantly associated with death (hazard ratio [HR] = 2.68; 95 % CI, 1.16–6.15; P = 0.020) in multivariable analysis. Patients with a higher TLR had significantly worse OS than patients with a lower TLR (5-year overall survival, 61 % vs. 79.4 %; P = 0.006). In the TACE cohort, the Model for End-Stage Liver Disease (MELD) score (≥8) was a significant independent prognostic factor for OS (HR = 3.34; 95 % CI, 1.49–7.48; P = 0.003), whereas TLR was not associated with OS. The Kaplan-Meier curves showed significantly poorer OS in patients with higher MELD scores (≥8) than in those with lower MELD scores (5-year survival rate, 33.1 % vs. 79.6 %; P < 0.001).


Conclusions

Pretreatment TLR measured using FDG PET/CT was an independent prognostic factor for OS in patients with BCLC stage 0 or A HCC undergoing curative treatment. In contrast, underlying liver function appeared to be important in predicting the prognosis of patients undergoing TACE.
Keimyung Author(s)(Kor)
송봉일
Publisher
School of Medicine
Citation
Kyung-Han Lee et al. (2016). Prognostic value of 18F-fluorodeoxyglucose positron emission tomography/computed tomography in patients with Barcelona Clinic Liver Cancer stages 0 and A hepatocellular carcinomas: a multicenter retrospective cohort study. European Journal of Nuclear Medicine and Molecular Imaging, 43(9), 1638–1645. doi: 10.1007/s00259-016-3348-y
Type
Article
ISSN
1619-7070
Source
https://link.springer.com/article/10.1007%2Fs00259-016-3348-y
DOI
10.1007/s00259-016-3348-y
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/32754
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Nuclear Medicine (핵의학)
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