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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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Kaplan-Meier plots for recurrence-free survival according to combined factors with tumor burden and SUVmax. (A) Tumor size (P < 0.001) (B) Node status (P < 0.001) (C) Stage (P = 0.001). SUVmax, Maximum standardized uptake value. All P-values were calculated by the log-rank test.
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Fig3: Kaplan-Meier plots for recurrence-free survival according to combined factors with tumor burden and SUVmax. (A) Tumor size (P < 0.001) (B) Node status (P < 0.001) (C) Stage (P = 0.001). SUVmax, Maximum standardized uptake value. All P-values were calculated by the log-rank test.

Mentions: Four patient groups were classified according to SUVmax and tumor size: (1) tumor size ≤2 cm and SUVmax <4; (2) tumor size >2 cm and SUVmax <4; (3) tumor size ≤2 cm and SUVmax ≥4; and (4) tumor size >2 cm and SUVmax ≥4. The RFS of the four groups differed significantly (P < 0.001) (Figure 3A). Within the groups of large tumor size (>2 cm) and small tumor size (≤2 cm), RFS differed significantly according to the SUVmax (P = 0.049 and P = 0.009, respectively). Conversely, within the groups of high SUVmax and low SUVmax, RFS did not differ according to tumor size (P = 0.350 and P = 0.096, respectively).Figure 3


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)

Kaplan-Meier plots for recurrence-free survival according to combined factors with tumor burden and SUVmax. (A) Tumor size (P < 0.001) (B) Node status (P < 0.001) (C) Stage (P = 0.001). SUVmax, Maximum standardized uptake value. All P-values were calculated by the log-rank test.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Fig3: Kaplan-Meier plots for recurrence-free survival according to combined factors with tumor burden and SUVmax. (A) Tumor size (P < 0.001) (B) Node status (P < 0.001) (C) Stage (P = 0.001). SUVmax, Maximum standardized uptake value. All P-values were calculated by the log-rank test.
Mentions: Four patient groups were classified according to SUVmax and tumor size: (1) tumor size ≤2 cm and SUVmax <4; (2) tumor size >2 cm and SUVmax <4; (3) tumor size ≤2 cm and SUVmax ≥4; and (4) tumor size >2 cm and SUVmax ≥4. The RFS of the four groups differed significantly (P < 0.001) (Figure 3A). Within the groups of large tumor size (>2 cm) and small tumor size (≤2 cm), RFS differed significantly according to the SUVmax (P = 0.049 and P = 0.009, respectively). Conversely, within the groups of high SUVmax and low SUVmax, RFS did not differ according to tumor size (P = 0.350 and P = 0.096, respectively).Figure 3

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