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High FDG uptake in PET/CT predicts worse prognosis in patients with metastatic gastric adenocarcinoma

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Abstract

Purpose

We evaluated the role of FDG-PET/CT in patients with metastatic gastric adenocarcinoma before palliative chemotherapy to predict prognosis and chemotherapeutic response.

Methods

The study included 35 consecutive newly diagnosed patients with metastatic gastric adenocarcinoma who underwent FDG-PET/CT before palliative chemotherapy. Maximum standardized uptake value (SUVmax) of the primary tumor was assessed to evaluate survival and chemotherapeutic response. Survival analysis was performed for time to progression and overall survival using the Kaplan–Meier method. Cox proportional hazard models were used to determine independent prognostic factors.

Results

All primary tumors were visualized using FDG-PET/CT (mean SUVmax = 8.1 ± 4.5, range 2.5–22.1). Sensitivity, specificity, and accuracy of FDG-PET/CT in detection of solid organ metastasis were 95.2% (20/21), 100% (14/14), and 97.1% (34/35), respectively. No significant difference of primary tumor SUVmax was found among the chemotherapeutic response groups. Univariate survival analysis demonstrated ECOG performance status (≥2), presence of solid organ metastasis, number of organs involved in distant metastasis (≥2), and SUVmax of the primary tumor (>8) as significant predictors for poor overall survival. Multivariate survival analysis showed SUVmax of the primary tumor (P = 0.048), presence of solid organ metastasis (P = 0.015), and ECOG performance status (P = 0.002) as significant independent prognostic predictors for overall survival.

Conclusions

High FDG uptake of the primary tumor in patients with metastatic gastric adenocarcinoma is associated with poor overall survival. Assessment of tumor FDG uptake has limited value for prediction of chemotherapeutic response, but provides useful information regarding prognosis.

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Acknowledgments

This work was supported in part by Konkuk University in 2008.

Conflict of interest statement

We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Department of Nuclear Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, 4-12 Hwayang-dong, Kwangjin-gu, Seoul, Korea

    Hyun Woo Chung & Young So

  2. Department of Nuclear Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 108, Pyoung-dong, Jongro-gu, Seoul, Korea

    Eun Jeong Lee

  3. Department of Internal Medicine, Division of Hematology-Oncology, Konkuk University Medical Center, Konkuk University School of Medicine, 4-12 Hwayang-dong, Kwangjin-gu, Seoul, Korea

    Yo-Han Cho, So Young Yoon, Sung-Yong Kim & Mark Hong Lee

  4. Department of Internal Medicine, Division of Gastroenterology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea

    Jeong Hwan Kim, Sun-Young Lee, In-Kyung Sung & Hyung-Seok Park

  5. Department of Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea

    Moon-Won Yoo & Kyung-Yung Lee

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  1. Hyun Woo Chung
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  2. Eun Jeong Lee
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  13. Kyung-Yung Lee
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Correspondence to Yo-Han Cho.

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Chung, H.W., Lee, E.J., Cho, YH. et al. High FDG uptake in PET/CT predicts worse prognosis in patients with metastatic gastric adenocarcinoma. J Cancer Res Clin Oncol 136, 1929–1935 (2010). https://doi.org/10.1007/s00432-010-0852-5

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  • DOI: https://doi.org/10.1007/s00432-010-0852-5

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