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KMID : 1148920090430050429
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Nuclear Medicine and Molecular Imaging
2009 Volume.43 No. 5 p.429 ~ p.435
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Prognostic Significance of Pre-operative FDG-PET in Colorectal Cancer Patients with Hepatic Metastasis
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Lee Hyo-Sang
Lee Won-Woo
Kim Duck-Woo
Kang Sung-Bum
Lee Kyoung-Ho
Lee Keun-Wook
Kim Jee-Hyun
Kim Sang-Eun
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Abstract
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Purpose: The purpose of this study was to assess the prognostic value of preoperative FDG-PET in colorectal cancer (CRC) patients with hepatic metastasis (HM).
Materials and Methods: 24 CRC patients (M:F=14:10; age, 63±10 yrs) with HM who had undergone preoperative FDG PET were included. Cure-intent surgery was performed in all the patients and HMs were controlled using resection (n=13), radio-frequency ablation (RFA) (n=7), and resection plus RFA (n=4). Potential prognostic markers tested were maxSUV of primary tumor, maxSUV of HM, maxSUV ratio of HM over primary tumor (M/P ratio), histologic grade, CEA level, venous/lymphatic/nerve invasion, T stage, N stage, no. of HM, no. of lymph node metastasis, and treatment modality of HM.
Results: 14 CRC patients developed a recurrence with a median follow-up duration of 244 days, whereas 10 patients did not develop recurrence with a median follow-up duration of 504 days. M/P ratios but other potential prognostic markers were significantly higher in the recurrent patients (0.72±0.14) than recurrence-free patients (0.54±0.23) (p=0.038). M/P ratio only was found to predict recurrence by Cox multivariate analysis (hazard ratio 37.7, 95% confidence interval 2.01-706.1, p=0.016). The 11 patients with lower M/P ratio of <0.61 had significantly better disease-free survival rate than the 13 patients with higher M/P ratio (≥0.61) (p=0.026).
Conclusion: maxSUV ratio of HM over primary tumor (M/P ratio) may be useful for prognosis prediction of CRC patients with HM. Higher FDG uptake of HM than that of primary tumor may indicate a more advanced status in stage IV CRC.
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KEYWORD
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Colorectal cancer, hepatic metastasis, prognosis, fluorodeoxyglucose, positron emission tomography
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