Prognostic value of 18 F-fluorodeoxyglucose positron emission tomography in patients with gastric neuroendocrine carcino
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ORIGINAL ARTICLE
Prognostic value of 18F-fluorodeoxyglucose positron emission tomography in patients with gastric neuroendocrine carcinoma and mixed adenoneuroendocrine carcinoma Sun Min Lim1,2 • Hyunki Kim3 • Beodeul Kang4 • Hyo Song Kim1 • Sun Young Rha1 • Sung Hoon Noh5 • Woo Jin Hyung5 • Jae-Ho Cheong5 Hyoung-Il Kim5 • Hyun Cheol Chung1 • Mijin Yun6 • Arthur Cho6 • Minkyu Jung1
•
Received: 27 October 2015 / Accepted: 17 January 2016 Ó The Japanese Society of Nuclear Medicine 2016
Abstract Objective Gastric neuroendocrine carcinomas (NEC) and mixed adenoneuroendocrine carcinoma (MANEC) are very rare, aggressive tumors of the stomach. We aimed to examine predictive role of pretreatment 18F-FDG PET/CTassessed metabolic parameter of primary tumors and metastases in patients with gastric NEC and MANEC. Methods We conducted a review of the 27 patients with histopathologically confirmed NECs (n = 10) and MANEC (n = 17) of the stomach at our institution between January 2005 and December 2012. All patients underwent 18F-FDG-PET examination at diagnosis.
A. Cho and M. Jung contributed equally. & Arthur Cho [email protected] & Minkyu Jung [email protected] 1
Division of Medical Oncology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
2
Division of Medical Oncology, Department of Internal Medicine, CHA Bundang Medical Center, CHA University, 59 Yatap-ro, Seongnam, Gyeonggido 13496, Republic of Korea
3
Department of Pathology, Yonsei University College of Medicine, Seoul, Republic of Korea
4
Division of Hematology and Medical Oncology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
5
Department of Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea
6
Department of Nuclear Medicine, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
Metabolic parameters [SUVmax, SUVmean, metabolic tumor volume (MTV) and total lesion glycolysis (TLG)] of the primary tumor and metastases on baseline PET/CT were analyzed. Results The median follow-up duration was 39.4 months (95 % CI 20.0–58.1 months) and the median overall survival (OS) was 25.7 months (95 % CI 14.1–37.2 months). All gastric lesions were well visualized (average SUVmax = 12.0, range 3.0–41.8). When subjects were divided into two groups by ROC cut-off value of 210.9 and 612, patients with high TLG in primary lesion and metastases showed poorer prognosis compared to low TLG patients (P = 0.09, P = 0.002, respectively). In the subanalysis of patients with metastasis (n = 12), patients with high TLG in whole body tumor showed significantly shorter OS compared to those with low TLG (31.7 ± 11.4 vs. 7.2 ± 2.1 months, P = 0.006). Conclusion 18F-FDG PET/CT is useful in evaluating prognosis of advanced gastric cancer with neuroendocrine carcinoma components. Baseline MTV of primary gastric cancer with metastatic disease, and MTV, TLG of metastases may be prognostic markers in patients with gastric NEC and MANEC. Keywords
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