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Prognosis estimation under the light of metabolic tumor parameters on initial FDG-PET/CT in patients with primary extranodal lymphoma

View Article: PubMed Central - PubMed

ABSTRACT

Background: Non-Hodgkin’s lymphomas arising from the tissues other than primary lymphatic organs are named primary extranodal lymphoma. Most of the studies evaluated metabolic tumor parameters in different organs and histopathologic variants of this disease generally for treatment response. We aimed to evaluate the prognostic value of metabolic tumor parameters derived from initial FDG-PET/CT in patients with a medley of primary extranodal lymphoma in this study.

Patients and methods: There were 67 patients with primary extranodal lymphoma for whom FDG-PET/CT was requested for primary staging. Quantitative PET/CT parameters: maximum standardized uptake value (SUVmax), average standardized uptake value (SUVmean), metabolic tumor volume (MTV) and total lesion glycolysis (TLG) were used to estimate disease-free survival and overall survival.

Results: SUVmean, MTV and TLG were found statistically significant after multivariate analysis. SUVmean remained significant after ROC curve analysis. Sensitivity and specificity were calculated as 88% and 64%, respectively, when the cut-off value of SUVmean was chosen as 5.15. After the investigation of primary presentation sites and histo-pathological variants according to recurrence, there is no difference amongst the variants. Primary site of extranodal lymphomas however, is statistically important (p = 0.014). Testis and central nervous system lymphomas have higher recurrence rate (62.5%, 73%, respectively).

Conclusions: High SUVmean, MTV and TLG values obtained from primary staging FDG-PET/CT are potential risk factors for both disease-free survival and overall survival in primary extranodal lymphoma. SUVmean is the most significant one amongst them for estimating recurrence/metastasis.

No MeSH data available.


Kaplan-Meier curve of SUVmean with a cut-off value of 5.15.
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j_raon-2016-0045_fig_002: Kaplan-Meier curve of SUVmean with a cut-off value of 5.15.

Mentions: Univariate cox regression was performed for all potential risk factors (sex, age, pathology, primary site, SUVmax, SUVmean, MTV, TLG) impacting recurrence/metastasis development. Factors with p < 0.2 values after univariate analysis (SUVmax, SUVmean, MTV, TLG and age) were processed with multivariate model. SUVmean, MTV and TLG were found statistically significant after multivariate analysis. The results of univariate and multivariate Cox regression analyses are shown in Table 2, 3. ROC curve drawn to evaluate the diagnostic value of SUVmean, MTV and TLG is shown in Figure 1. SUVmean remained significant after ROC curve analysis. One unit increment of SUVmean amplifies recurrence rate 1.4 times. Sensitivity and specificity were calculated as 88% and 64%, respectively, when the cut-off value of SUVmean was set at 5.15. Cut-off values, sensitivity and specificity of SUVmean, MTV and TLG are shown in Table 4. SUVmean was dichotomized by splitting two groups according to ROC curve. Kaplan-Meier method with log-rank test was used to compare DFS of SUVmean groups. Kaplan-Meier curve drawn for SUVmean with a cut-off value of 5.15 is shown in Figure 2. When we analyze metabolic tumor parameters for histopatho-logical subtypes, SUVmax and SUVmean prove meaningful (p = 0.003 and p = 0.005, respectively). After the investigation of primary presentation sites and histopathological variants according to recurrence, there is no difference amongst the variants. Primary site (organ) of extranodal lymphomas however, appears to be statistically important (p = 0.014). Testis and CNS lymphomas have higher recurrence rate (62.5%, 73%, respectively). Risk of recurrence/metastasis development increases 3.5 times in testis lymphomas and 216 times in CNS lymphomas with comparison to GIS lymphomas.


Prognosis estimation under the light of metabolic tumor parameters on initial FDG-PET/CT in patients with primary extranodal lymphoma
Kaplan-Meier curve of SUVmean with a cut-off value of 5.15.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC5120580&req=5

j_raon-2016-0045_fig_002: Kaplan-Meier curve of SUVmean with a cut-off value of 5.15.
Mentions: Univariate cox regression was performed for all potential risk factors (sex, age, pathology, primary site, SUVmax, SUVmean, MTV, TLG) impacting recurrence/metastasis development. Factors with p < 0.2 values after univariate analysis (SUVmax, SUVmean, MTV, TLG and age) were processed with multivariate model. SUVmean, MTV and TLG were found statistically significant after multivariate analysis. The results of univariate and multivariate Cox regression analyses are shown in Table 2, 3. ROC curve drawn to evaluate the diagnostic value of SUVmean, MTV and TLG is shown in Figure 1. SUVmean remained significant after ROC curve analysis. One unit increment of SUVmean amplifies recurrence rate 1.4 times. Sensitivity and specificity were calculated as 88% and 64%, respectively, when the cut-off value of SUVmean was set at 5.15. Cut-off values, sensitivity and specificity of SUVmean, MTV and TLG are shown in Table 4. SUVmean was dichotomized by splitting two groups according to ROC curve. Kaplan-Meier method with log-rank test was used to compare DFS of SUVmean groups. Kaplan-Meier curve drawn for SUVmean with a cut-off value of 5.15 is shown in Figure 2. When we analyze metabolic tumor parameters for histopatho-logical subtypes, SUVmax and SUVmean prove meaningful (p = 0.003 and p = 0.005, respectively). After the investigation of primary presentation sites and histopathological variants according to recurrence, there is no difference amongst the variants. Primary site (organ) of extranodal lymphomas however, appears to be statistically important (p = 0.014). Testis and CNS lymphomas have higher recurrence rate (62.5%, 73%, respectively). Risk of recurrence/metastasis development increases 3.5 times in testis lymphomas and 216 times in CNS lymphomas with comparison to GIS lymphomas.

View Article: PubMed Central - PubMed

ABSTRACT

Background: Non-Hodgkin&rsquo;s lymphomas arising from the tissues other than primary lymphatic organs are named primary extranodal lymphoma. Most of the studies evaluated metabolic tumor parameters in different organs and histopathologic variants of this disease generally for treatment response. We aimed to evaluate the prognostic value of metabolic tumor parameters derived from initial FDG-PET/CT in patients with a medley of primary extranodal lymphoma in this study.

Patients and methods: There were 67 patients with primary extranodal lymphoma for whom FDG-PET/CT was requested for primary staging. Quantitative PET/CT parameters: maximum standardized uptake value (SUVmax), average standardized uptake value (SUVmean), metabolic tumor volume (MTV) and total lesion glycolysis (TLG) were used to estimate disease-free survival and overall survival.

Results: SUVmean, MTV and TLG were found statistically significant after multivariate analysis. SUVmean remained significant after ROC curve analysis. Sensitivity and specificity were calculated as 88% and 64%, respectively, when the cut-off value of SUVmean was chosen as 5.15. After the investigation of primary presentation sites and histo-pathological variants according to recurrence, there is no difference amongst the variants. Primary site of extranodal lymphomas however, is statistically important (p = 0.014). Testis and central nervous system lymphomas have higher recurrence rate (62.5%, 73%, respectively).

Conclusions: High SUVmean, MTV and TLG values obtained from primary staging FDG-PET/CT are potential risk factors for both disease-free survival and overall survival in primary extranodal lymphoma. SUVmean is the most significant one amongst them for estimating recurrence/metastasis.

No MeSH data available.