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Whole Body Metabolic Tumor Volume and Total Lesion Glycolysis Predict Survival in Patients with Adrenocortical Carcinoma

Annals of Surgical Oncology volume 22, pages 714–720 (2015)Cite this article

Abstract

Background

Adrenocortical carcinoma (ACC) is a rare but lethal malignancy with few reliable prognostic markers. FDG-PET metabolic parameters have been shown to predict survival in several cancers. The objective was to determine if metabolic tumor volume (MTV), total lesion glycolysis (TLG), and maximum standardized uptake value (SUVmax) could serve as prognostic markers in patients with ACC.

Methods

A total of 30 patients with ACC prospectively underwent 18F-FDG PET/CT prior to treatment. Whole body MTV, TLG, and SUVmax were measured by a semiautomatic method. A median cutoff was used to determine an association with overall survival (OS) from the time of 18F-FDG PET/CT by the Kaplan–Meier method.

Results

Patients with high whole body MTV (>87.0 mL),TLG (>229.4 SUVlbm*mL), or SUVmax (>8.9 SUV) had a worse OS compared with those with low whole body MTV (median OS, 24 vs 45.1 months, p < .01), TLG (median OS, 24 vs 40.3 months, p < .005), or SUVmax (median OS, 23.7 vs 35.5 months, p < .02). In patients who had operable disease (n = 23), high whole body MTV (>87.0 mL) and TLG (>229.4 SUVlbm*mL) had a worse OS compared with those with low whole body MTV (median OS, 25.1 vs 45.1 months, p < .05) and TLG (median OS, 25.1 vs 40.3 months, p < .05), but a high SUVmax (>8.9 SUV) was not associated with worse OS (p = .11).

Conclusions

Patients with ACC and a high whole body MTV, TLG, and SUVmax have a worse prognosis and OS. Measurement of whole body MTV and TLG may be helpful for guiding therapy for patients with ACC.

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Acknowledgment

This research was supported by the intramural research program of the Center for Cancer Research, National Cancer Institute, National Institutes of Health and the National Institutes of Health (NIH) Medical Research Scholars Program, a public–private partnership supported jointly by the NIH and generous contributions to the Foundation for the NIH from Pfizer Inc., The Doris Duke Charitable Foundation, The Newport Foundation, The American Association for Dental Research, The Howard Hughes Medical Institute, and the Colgate-Palmolive Company, as well as other private donors. For a complete list, please visit the Foundation website at:http://fnih.org/work/education-training-0/medical-research-scholars-program.

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Author notes

    Affiliations

    1. Endocrine Oncology Branch, National Cancer Institute, NIH, Bethesda, MD, USA

      Kei Satoh BA, Dhaval Patel MD, Naris Nilubol MD & Electron Kebebew MD, FACS

    2. Icahn School of Medicine at Mount Sinai, New York, NY, USA

      Kei Satoh BA

    3. PET Department, Clinical Center, NIH, Bethesda, MD, USA

      William Dieckmann MS

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    1. Kei Satoh BA
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    2. Dhaval Patel MD
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    Correspondence to Dhaval Patel MD.

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    K. Satoh and D. Patel have contributed equally.

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    Satoh, K., Patel, D., Dieckmann, W. et al. Whole Body Metabolic Tumor Volume and Total Lesion Glycolysis Predict Survival in Patients with Adrenocortical Carcinoma. Ann Surg Oncol 22, 714–720 (2015). https://doi.org/10.1245/s10434-015-4813-8

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    Keywords

    • Overall Survival
    • Standard Uptake Value
    • Median Overall Survival
    • Metabolic Tumor Volume
    • Total Lesion Glycolysis