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. 2020 Apr 29;29(2):65-71.
doi: 10.4274/mirt.galenos.2020.40316.

The Impact of Primary Tumor and Locoregional Metastatic Lymph Node SUVmax on Predicting Survival in Patients with Rectal Cancer

Göksel Alçın  1 , Yasemin Şanlı  2 , Gülçin Yeğen  3 , Esra Kaytan Sağlam  4 , Tevfik Fikret Çermik  1
Affiliations

The Impact of Primary Tumor and Locoregional Metastatic Lymph Node SUVmax on Predicting Survival in Patients with Rectal Cancer

Göksel Alçın et al. Mol Imaging Radionucl Ther. .

Abstract
in English, Turkish

Objectives: The aim of this study was to evaluate the impact of maximum standard uptake value (SUVmax) of the primary tumor and locoregional metastatic lymph node in predicting survival in patients with the preoperative rectal adenocarcinoma.

Methods: One hundred and fifteen patients [mean age ± standard deviation (SD): 58.7±11.4 years] with biopsy-proven rectal adenocarcinoma underwent 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) imaging for the staging were included in this study. All patients were followed-up for a minimum of 12 months (mean ± SD: 29.7±13.5 months). Tumor-node-metastasis 2017 clinical staging, SUVmax of the primary rectal tumor and locoregional lymph nodes on the PET/CT studies were evaluated.

Results: All patients had increased FDG activity of the primary tumor. The mean ± SD SUVmax of the primary tumor and locoregional metastatic lymph node were 21.0±9.1 and 4.6±2.8, respectively. Primary tumor SUVmax did not have an effect on predicting survival (p=0.525) however locoregional metastatic lymph node SUVmax had an effect (p<0.05) on predicting survival. Clinical stage of the disease was a factor predicting survival (p<0.001).

Conclusion: 18F-FDG PET/CT is an effective imaging modality for detecting primary tumors and metastases in rectal adenocarcinoma and clinical stage assessment with PET/CT had an effect on predicting survival. Furthermore, in our study locoregional lymph node SUVmax was defined as a factor in predicting survival.

Amaç: Çalışmamızın amacı preoperatif rektum adenokanserli olan hastalarda sağkalımı öngörmede primer tümör ve lokorejyonel metastatik lenf nodu maksimum standart alım değeri (SUVmaks) değerinin etkinliğini değerlendirmektir.

Yöntem: Bu çalışmaya, biyopsiyle kanıtlanmış rektal adenokarsinoma ile evreleme amaçlı 18F-florodeoksiglikoz (FDG) pozitron emisyon tomografi/bilgisayarlı tomografi (PET/BT) görüntüleme yapılan 115 hasta [ortalama yaş ± standart sapma (SS): 58,7±11,4 yıl] dahil edildi. Tüm hastalar en az 12 ay (ortalama ± SS: 29,7±13,5 ay) takip edildi. Tümör-nodül-metastaz 2017 klinik evreleme, primer rektal tümör SUVmaks ve lokorejyonel lenf nodu SUVmaks değerlendirildi.

Bulgular: Tüm hastalarda primer tümöre ait artmış FDG tutulumu saptandı. Primer tümör ve lokorejyonel metastatik lenf nodu ortalama SUVmaks’ları sırasıyla 21,0±9,1 ve 4,6±2,8 idi. Primer tümör SUVmaks’ın sağkalımı öngörmede bir etkisi saptanmamış olup (p=0,525) lokorejyonel metastatik lenf nodu SUVmaks’ın sağkalımı öngörmede etkisi saptandı (p<0,05). Hastalığın klinik evresi sağkalımı öngören bir faktördü (p<0,001).

Sonuç: 18F-FDG PET/BT rektum kanserinde primer tümör ve metastazlarının saptanmasında etkili bir görüntüleme yöntemi olup lokorejyonel lenf nodu SUVmaks değerlerinin prognostik değerinin bulunduğu ve rektum kanserinin tedavi öncesi preoperatif evrelemede hastaların tedavi yönetimine önemli katkılar sağlayacağı düşünülmüştür.

Keywords: 18F-FDG PET/CT; Rectal adenocarcinoma; SUVmax; prognosis; staging.

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Conflict of interest statement

Conflict of Interest: No conflict of interest was declared by the authors.

Figures

Figure 1
Figure 1
Kaplan-Meier survival analysis of all patients
Figure 2
Figure 2
ROC analysis of lymph node SUVmax (blue) with DFS ROC: Receiver operating characteristic, SUVmax: Maximum standard uptake value, DFS: Disease-free survival
See this image and copyright information in PMC

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