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Standardized uptake value of ¹⁸F-fluorodeoxyglucose positron emission tomography for prediction of tumor recurrence in breast cancer beyond tumor burden.

Ahn SG, Park JT, Lee HM, Lee HW, Jeon TJ, Han K, Lee SA, Dong SM, Ryu YH, Son EJ, Jeong J - Breast Cancer Res. (2014)

Bottom Line: In multivariate analysis for RFS, SUVmax carried independent prognostic significance (hazard ratio, 2.39; 95% confidence interval, 1.20 to 4.76; P = 0.012).Similarly, SUVmax had prognostic value in combination with nodal status (negative versus positive) or stage (I versus II and III) (P < 0.001 and P = 0.001, respectively).In hormone receptor-positive disease, SUVmax remained a significant prognostic factor for RFS based on multivariate analysis.

View Article: PubMed Central - PubMed

ABSTRACT

Introduction: 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) can reveal the metabolic activity of malignant tumors. Recent advances gained from molecular studies suggest that tumor biology can be a good predictor of prognosis in breast cancer. We compared the ability of maximum standardized uptake values (SUVmax) derived by FDG-PET with tumor burden in predicting tumor recurrence for patients with breast cancer.

Methods: 496 patients with breast cancer who underwent preoperative FDG-PET between April 2004 and May 2009 were retrospectively identified. SUVmax was obtained by FDG-PET, and the cutoff point was defined using a time-dependent receiver operating characteristic curve for recurrence-free survival (RFS). The primary endpoint was RFS.

Results: In multivariate analysis for RFS, SUVmax carried independent prognostic significance (hazard ratio, 2.39; 95% confidence interval, 1.20 to 4.76; P = 0.012). When the patients were classified into four groups according to the combined factors of tumor size (≤2 cm versus >2 cm) and SUVmax (<4 versus ≥4), RFS differed significantly (P < 0.001). Similarly, SUVmax had prognostic value in combination with nodal status (negative versus positive) or stage (I versus II and III) (P < 0.001 and P = 0.001, respectively). In hormone receptor-positive disease, SUVmax remained a significant prognostic factor for RFS based on multivariate analysis.

Conclusions: Our results highlight the prognostic value of FDG-PET in prediction of tumor relapse for patients with breast cancer. Particularly in patients with hormone receptor-positive disease, the tumor metabolic information provided by FDG-PET is more significantly correlated with prognosis than tumor burden.

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CONSORT chart outlining the study plan. DCIS, Ductal carcinoma in situ; FDG-PET, 18F-fluorodeoxyglucose positron emission tomography; FISH, Fluorescence in situ hybridization; HER2, Human epidermal growth factor receptor 2; IHC Immunohistochemistry.
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Fig1: CONSORT chart outlining the study plan. DCIS, Ductal carcinoma in situ; FDG-PET, 18F-fluorodeoxyglucose positron emission tomography; FISH, Fluorescence in situ hybridization; HER2, Human epidermal growth factor receptor 2; IHC Immunohistochemistry.

Mentions: Between April 2004 and May 2009, 1,053 women consecutively underwent surgery for breast cancer at our institution. Of these 1,053 patients, 835 underwent preoperative FDG-PET as a part of their routine preoperative staging. Patients were excluded on the basis of the following criteria: known bilateral breast cancer (n = 31), preoperative chemotherapy (because chemotherapy can affect tumor characteristics related to FDG uptake) (n = 94), ductal carcinoma in situ (n = 135) and distant metastases at initial assessment (n = 42). Among these patients, 501 women of interest were identified. Patients missing data for any immunohistochemical marker were excluded (n = 3). Patients with an immunohistochemistry (IHC) scores of 2+ for human epidermal growth factor receptor 2 (HER2), but without fluorescence in situ hybridization (FISH) results for HER2 amplification, were also excluded (n = 2). Data for the remaining 496 patients were entered into the analysis (Figure 1).Figure 1


Standardized uptake value of ¹⁸F-fluorodeoxyglucose positron emission tomography for prediction of tumor recurrence in breast cancer beyond tumor burden.

Ahn SG, Park JT, Lee HM, Lee HW, Jeon TJ, Han K, Lee SA, Dong SM, Ryu YH, Son EJ, Jeong J - Breast Cancer Res. (2014)

CONSORT chart outlining the study plan. DCIS, Ductal carcinoma in situ; FDG-PET, 18F-fluorodeoxyglucose positron emission tomography; FISH, Fluorescence in situ hybridization; HER2, Human epidermal growth factor receptor 2; IHC Immunohistochemistry.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4308858&req=5

Fig1: CONSORT chart outlining the study plan. DCIS, Ductal carcinoma in situ; FDG-PET, 18F-fluorodeoxyglucose positron emission tomography; FISH, Fluorescence in situ hybridization; HER2, Human epidermal growth factor receptor 2; IHC Immunohistochemistry.
Mentions: Between April 2004 and May 2009, 1,053 women consecutively underwent surgery for breast cancer at our institution. Of these 1,053 patients, 835 underwent preoperative FDG-PET as a part of their routine preoperative staging. Patients were excluded on the basis of the following criteria: known bilateral breast cancer (n = 31), preoperative chemotherapy (because chemotherapy can affect tumor characteristics related to FDG uptake) (n = 94), ductal carcinoma in situ (n = 135) and distant metastases at initial assessment (n = 42). Among these patients, 501 women of interest were identified. Patients missing data for any immunohistochemical marker were excluded (n = 3). Patients with an immunohistochemistry (IHC) scores of 2+ for human epidermal growth factor receptor 2 (HER2), but without fluorescence in situ hybridization (FISH) results for HER2 amplification, were also excluded (n = 2). Data for the remaining 496 patients were entered into the analysis (Figure 1).Figure 1

Bottom Line: In multivariate analysis for RFS, SUVmax carried independent prognostic significance (hazard ratio, 2.39; 95% confidence interval, 1.20 to 4.76; P = 0.012).Similarly, SUVmax had prognostic value in combination with nodal status (negative versus positive) or stage (I versus II and III) (P < 0.001 and P = 0.001, respectively).In hormone receptor-positive disease, SUVmax remained a significant prognostic factor for RFS based on multivariate analysis.

View Article: PubMed Central - PubMed

ABSTRACT

Introduction: 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) can reveal the metabolic activity of malignant tumors. Recent advances gained from molecular studies suggest that tumor biology can be a good predictor of prognosis in breast cancer. We compared the ability of maximum standardized uptake values (SUVmax) derived by FDG-PET with tumor burden in predicting tumor recurrence for patients with breast cancer.

Methods: 496 patients with breast cancer who underwent preoperative FDG-PET between April 2004 and May 2009 were retrospectively identified. SUVmax was obtained by FDG-PET, and the cutoff point was defined using a time-dependent receiver operating characteristic curve for recurrence-free survival (RFS). The primary endpoint was RFS.

Results: In multivariate analysis for RFS, SUVmax carried independent prognostic significance (hazard ratio, 2.39; 95% confidence interval, 1.20 to 4.76; P = 0.012). When the patients were classified into four groups according to the combined factors of tumor size (≤2 cm versus >2 cm) and SUVmax (<4 versus ≥4), RFS differed significantly (P < 0.001). Similarly, SUVmax had prognostic value in combination with nodal status (negative versus positive) or stage (I versus II and III) (P < 0.001 and P = 0.001, respectively). In hormone receptor-positive disease, SUVmax remained a significant prognostic factor for RFS based on multivariate analysis.

Conclusions: Our results highlight the prognostic value of FDG-PET in prediction of tumor relapse for patients with breast cancer. Particularly in patients with hormone receptor-positive disease, the tumor metabolic information provided by FDG-PET is more significantly correlated with prognosis than tumor burden.

Show MeSH
Related in: MedlinePlus