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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 a combined factor that includes both tumor burden and SUVmaxin hormone receptor-positive cancer. (A) Tumor size (P = 0.028) (B) Node status (P = 0.006) (C) Stage (P = 0.029). SUVmax, Maximum standardized uptake value. All P-values were calculated by the log-rank test.
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Fig4: Kaplan-Meier plots for recurrence-free survival according to a combined factor that includes both tumor burden and SUVmaxin hormone receptor-positive cancer. (A) Tumor size (P = 0.028) (B) Node status (P = 0.006) (C) Stage (P = 0.029). SUVmax, Maximum standardized uptake value. All P-values were calculated by the log-rank test.

Mentions: The prognostic value of SUVmax combined with tumor burden was also assessed in hormone receptor–positive breast cancer. When the patients were classified into four groups according to both combined factors, RFS differed significantly (P < 0.001) (Figure 4A). There was no difference in RFS when patients were stratified by tumor size within the groups with high SUVmax and low SUVmax (P = 0.950 and P = 0.688, respectively). However, within the groups with small tumor sizes (≤2 cm), a significantly reduced RFS was found in patients with high SUVmax (P = 0.044). In patients with large tumor sizes (>2 cm), RFS did not differ significantly according to SUVmax (P = 0.065), possibly due to the limited number of patients (n = 122).Figure 4


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 a combined factor that includes both tumor burden and SUVmaxin hormone receptor-positive cancer. (A) Tumor size (P = 0.028) (B) Node status (P = 0.006) (C) Stage (P = 0.029). 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

Fig4: Kaplan-Meier plots for recurrence-free survival according to a combined factor that includes both tumor burden and SUVmaxin hormone receptor-positive cancer. (A) Tumor size (P = 0.028) (B) Node status (P = 0.006) (C) Stage (P = 0.029). SUVmax, Maximum standardized uptake value. All P-values were calculated by the log-rank test.
Mentions: The prognostic value of SUVmax combined with tumor burden was also assessed in hormone receptor–positive breast cancer. When the patients were classified into four groups according to both combined factors, RFS differed significantly (P < 0.001) (Figure 4A). There was no difference in RFS when patients were stratified by tumor size within the groups with high SUVmax and low SUVmax (P = 0.950 and P = 0.688, respectively). However, within the groups with small tumor sizes (≤2 cm), a significantly reduced RFS was found in patients with high SUVmax (P = 0.044). In patients with large tumor sizes (>2 cm), RFS did not differ significantly according to SUVmax (P = 0.065), possibly due to the limited number of patients (n = 122).Figure 4

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