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Prognostic implication of 18F FDG-PET in patients with extrahepatic metastatic hepatocellular carcinoma undergoing systemic treatment, a retrospective cohort study

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Abstract

Purpose

The role of 18F FDG-PET in hepatocellular carcinoma (HCC) has not been firmly established. We conducted this study to investigate the clinical implication of SUVmax on 18F FDG-PET as a prognostic factor in patients with HCC, especially in the metastatic setting.

Methods

HCC patients with extrahepatic metastatic lesions were enrolled that were evaluated by 18F FDG-PET before palliative systemic therapy, between January 2002 and December 2009 at the Seoul National University Hospital. We retrospectively analyzed the clinical outcome and the value of the SUVmax.

Results

A total of 25 patients (men, 88.0%) were enrolled. The response rate and disease control rate was 18.2% (95% CI: 2.1–34.3) and 32.0% (95% CI: 16.3–56.5), respectively. The progression-free survival (PFS) and overall survival (OS) were 2.3 months (95% CI: 1.1–3.4) and 14.2 months (95% CI: 9.1–19.2), respectively. The univariate analysis of OS showed that SUVmax and alphafetoprotein (AFP) were significant prognostic factors (P = 0.023 and P = 0.006, respectively). The multivariate analysis of OS showed that SUVmax and AFP were significant prognostic factors (P = 0.008 and P = 0.006, respectively). SUVmax and AFP were independent prognostic factors for PFS, too (P = 0.010 and P = 0.016, respectively). When the patients were divided according to the SUVmax and AFP, the patients with an SUVmax < 4.9 and an AFP ≤ 400 ng/ml showed longer OS and PFS than the patients with SUVmax ≥ 4.9 or AFP > 400 ng/ml (26.7 months vs. 9.3 months, P < 0.001 and 5.6 months vs. 1.7 months, P = 0.012, respectively).

Conclusions

The SUVmax of the 18F FDG-PET has a prognostic value for OS and PFS in patients with metastatic HCC undergoing systemic therapy. The combined analysis of the SUVmax with AFP might provide more detailed prognostic information.

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Authors and Affiliations

  1. Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehagro, Chongno-gu, Seoul, 110-744, Korea

    Dong-Yeop Shin, Sae-Won Han, Do-Youn Oh, Seock-Ah Im, Tae-You Kim & Yung-Jue Bang

  2. Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea

    Sae-Won Han, Do-Youn Oh, Seock-Ah Im, Tae-You Kim & Yung-Jue Bang

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  1. Dong-Yeop Shin
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  2. Sae-Won Han
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Correspondence to Do-Youn Oh.

Additional information

This study was partly presented in 2010 Gastrointestinal Cancers Symposium, Orlando, FL, USA.

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Shin, DY., Han, SW., Oh, DY. et al. Prognostic implication of 18F FDG-PET in patients with extrahepatic metastatic hepatocellular carcinoma undergoing systemic treatment, a retrospective cohort study. Cancer Chemother Pharmacol 68, 165–175 (2011). https://doi.org/10.1007/s00280-010-1454-2

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