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The Predictive Value of Baseline Volumetric PET/CT Parameters on Treatment Response and Prognosis in Locally Advanced Rectal Cancer Treated with Neoadjuvant Chemoradiotherapy

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Abstract

Purpose

To investigate the prognostic effects of baseline volumetric PET/CT parameters including the maximum standard uptake value (SUVmax), metabolic tumor volume (MTV), and tumor lesion glycolysis (TLG) on treatment response and prognosis in locally advanced rectal cancer (LARC) treated with neoadjuvant chemoradiotherapy (NACRT).

Methods

Between 2015 and 2018, 51 patients with LARC treated with NACRT followed by surgery were included in this retrospective study. Patients were divided into 2 groups by tumor regression grade (TRG) as follows: group I = TRG 1 (no detectable cancer cells) + TRG 2 (single cells and/or small groups of cancer cells) and group II = TRG3 (residual tumor outgrown by fibrosis) + TRG 4 (remarkable fibrosis outgrown by tumor cells) + TRG 5 (no fibrosis with extensive residual cancer).

Results

Of the 51 patients, 34 (66.7%) were male. The median age was 55 (range, 37–78) years. According to TRG status, 14 (27.4%) patients were in group I and 37 (72.6%) patients were in group II. The area under the curve (95% CI) was 0.749 (0.593–0.905) in the ROC curve plotted for MTV. The cut-off value for MTV was 12, with 70% sensitivity and 65% specificity. MTV was ≥ 12 in 32 (62.8%) patients. MTV and TLG values were significantly different between groups I and II, whereas there was no significant difference between the groups in terms of SUVmax values (p = 0.006, p = 0.033, and p = 0.673, respectively). The disease-free survival was not reached in patients with MTV < 12 vs. 20 months in those with MTV ≥ 12 (p = 0.323). In multivariate analysis, MTV (OR, 95% Cl, 5.00 [1.17–21.383]) was found to be the factor that affected pathological complete response.

Conclusion

In LARC treated with NACRT, MTV prior to treatment can help predict the response to treatment.

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Authors and Affiliations

  1. Department of Medical Oncology, Yuzuncu Yil University Medical School, 65030, Van, Turkey

    Abdullah Sakin

  2. Department of Medical Oncology, University of Health Sciences, Van Training and Research Hospital, Van, Turkey

    Suleyman Sahin

  3. Department of Nuclear Medicine, University of Health Sciences, Prof. Dr Cemil, Tascıoglu City Hospital, İstanbul, Turkey

    Sevda Saglampınar Karyagar & Savas Karyagar

  4. Department of Medical Oncology, University of Health Sciences, Prof. Dr Cemil, Tascıoglu City Hospital, 34384, Istanbul, Turkey

    Mustafa atci & Sener Cihan

  5. Department of Radiation Oncology, University of Health Sciences, Prof. Dr Cemil, Tascıoglu City Hospital, 34384, Istanbul, Turkey

    Mustafa Halil Akboru

Authors
  1. Abdullah Sakin
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  2. Suleyman Sahin
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  4. Savas Karyagar
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Contributions

Concept-AS, SS, SSK, SC; design-AS, MMS, MHA, SC; supervision-SS, SK, MMA, SC; resources-AS, SSK, SK, MMA; materials-SK, MHA, MMA, SC; data collection and/or processing-AS, SS, SK, MHA; analysis and/or interpretation-SS, SSK, MMK, SC; literature search-AS, SS, MMA, SC; writing manuscript-AS, SS, SSK, SK; critical review-SS, SC; other-AS, SS, SSK, SK.

Corresponding author

Correspondence to Abdullah Sakin.

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Institutional Review Board Statement

All necessary procedures for this study were implemented based on the declaration of Helsinki. The ethics committee approval was taken from the Ethics Committee Board of University of Health Sciences Okmeydani Training and Research Hospital (ID: 48670771-514.10).

Informed Consent

The patients were not required to give informed consent for this study because the study utilized the anonymous retrospective data obtained after each patient accepted the treatment by a written consent.

Conflict of Interest

The authors declare that they have no conflict of interest.

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Sakin, A., Sahin, S., Karyagar, S.S. et al. The Predictive Value of Baseline Volumetric PET/CT Parameters on Treatment Response and Prognosis in Locally Advanced Rectal Cancer Treated with Neoadjuvant Chemoradiotherapy. J Gastrointest Canc 53, 341–347 (2022). https://doi.org/10.1007/s12029-021-00608-y

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  • DOI: https://doi.org/10.1007/s12029-021-00608-y

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