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Nomogram using F-18 fluorodeoxyglucose positron emission tomography/computed tomography for preoperative prediction of lymph node metastasis in gastric cancer

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Author(s)
Bong-Il Song
Keimyung Author(s)
Song, Bong Il
Department
Dept. of Nuclear Medicine (핵의학)
Journal Title
World J Gastrointest Oncol
Issued Date
2020
Volume
12
Issue
4
Keyword
FluorodeoxyglucoseGastric cancerLymph node metastasisPositron emission tomography/computed tomographyPrognosticationStandardized uptake value
Abstract
Background:
Lymph node (LN) metastasis is an important prognostic factor in patients with gastric cancer (GC). However, the evaluation of LN metastasis status in the preoperative setting is not accurate. Therefore, precise preoperative prediction of LN metastasis status is crucial for optimal treatment in patients with GC.

Aim:
To develop a preoperative nomogram for LN metastasis using F-18 fluorodeoxyglucose (F-18 FDG) positron emission tomography/computed tomography (PET/CT) and preoperative laboratory test findings in GC.

Methods:
In this study, the data of 566 GC patients who underwent preoperative F-18 FDG PET/CT and subsequent surgical resection were analyzed. The LN metastasis prediction model was developed in the training cohort and validated in the internal validation cohort. Routine preoperative laboratory tests, including albumin and carbohydrate antigen (CA) 19-9 were performed in all patients. Univariate and multivariable logistic regression was performed to validate the preoperative predictive indicators for LN metastasis.

Results:
Of the 566 patients, 232 (41%) had confirmed histopathologic LN metastasis. Univariate logistic regression revealed that the tumor location, blood hemoglobin, serum albumin levels, neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, CA 19-9, maximum standardized uptake value (SUVmax) of the primary tumor (T_SUVmax), and SUVmax of LN (N_SUVmax) were significantly associated with LN metastasis. In multivariate analysis, T_SUVmax (OR = 1.08; 95%CI: 1.02-1.15; P = 0.011) and N_SUVmax (OR = 1.49; 95%CI: 1.19-1.97; P = 0.002) were found to be significant predictive factors for LN metastasis. The LN metastasis prediction model using T_SUVmax, N_SUVmax, serum albumin, and CA 19-9 yielded an area under the curve (AUC) of 0.733 (95%CI: 0.683-0.784, P = 0.025) in the training cohort and AUC of 0.756 (95%CI: 0.678-0.833, P < 0.001) in the test cohort.

Conclusion:
T_SUVmax and N_SUVmax measured by preoperative F-18 FDG PET/CT are independent predictive factors for LN metastasis in GC.
Keimyung Author(s)(Kor)
송봉일
Publisher
School of Medicine (의과대학)
Citation
Bong-Il Song. (2020). Nomogram using F-18 fluorodeoxyglucose positron emission tomography/computed tomography for preoperative prediction of lymph node metastasis in gastric cancer. World J Gastrointest Oncol, 12(4), 447–456. doi: 10.4251/wjgo.v12.i4.447
Type
Article
ISSN
1948-5204
Source
https://www.wjgnet.com/1948-5204/full/v12/i4/447.htm
DOI
10.4251/wjgo.v12.i4.447
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/43330
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Nuclear Medicine (핵의학)
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