Annals of Oncology Advance Access originally published online on August 25, 2006
Annals of Oncology 2006 17(11):1650-1655; doi:10.1093/annonc/mdl180
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© 2006 European Society for Medical Oncology
gastrointestinal tumors |
FDG-PET for prediction of survival of patients with metastatic colorectal carcinoma
1 Department of Nuclear Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
2 Department of Surgery, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
3 Department of Medical Technology Assessment, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
4 Department of Medical Oncology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
*Correspondence to: Dr L. F. de Geus-Oei, Department of Nuclear Medicine (internal postal code 444), Radboud University Nijmegen Medical Centre, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands. Tel: +31-24-3614048; Fax: +31-24-3618942; E-mail: L.degeus-oei{at}nucmed.umcn.nl
Background: The current study focuses on the prognostic value of pretreatment metabolic activity in metastases as measured with [18F]fluorodeoxyglucose positron emission tomography (FDG-PET), as an indicator of survival in colorectal cancer.
Patients and methods: In a prospective series of 152 patients with metastatic colorectal cancer, of whom 67 were treated with resection of metastases and 85 with chemotherapy, standardized uptake values (SUV) as measured with FDG-PET, were calculated prior to treatment. Survival probabilities were estimated by Cox proportional regression analysis. For Kaplan–Meier analysis SUV was stratified by the median value. Survival differences were assessed using the log-rank test.
Results: SUV in metastases was a significant predictor for overall survival (hazard ratio 1.17, 95% confidence interval 1.06–1.30, P = 0.002), independent of the subsequent treatment. According to the median value of the patient population a low (SUV <4.26) and high uptake group (SUV >4.26) was defined. The median survival and the 2- and 3-year survival rates were 32 months, 59% and 45%, respectively, in the low-uptake group and 19 months, 37% and 28%, respectively, in the high-uptake group (P = 0.017).
Conclusion: A significant survival benefit was observed in patients with low FDG uptake in metastases of colorectal cancer.
Key words: FDG-PET, metastatic colorectal cancer, prognostic value, SUV
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