Nucl Med Mol Imaging.  2009 Oct;43(5):429-435.

Prognostic Significance of Pre-operative FDG-PET in Colorectal Cancer Patients with Hepatic Metastasis

• Lee HS
• Lee WW
• Kim DW
• Kang SB
• Lee KH
• Lee KW
• Kim JH
• Kim SE

Abstract

PURPOSE
The purpose of this study was to assess the prognostic value of preoperative FDG-PET in colorectal cancer (CRC) patients with hepatic metastasis (HM).
MATERIALS AND METHODS
24 CRC patients (M:F=14:10; age, 63+/-10 yrs) with HM who had undergone preoperative FDG PET were included. Cure-intent surgery was performed in all the patients and HMs were controlled using resection (n=13), radio-frequency ablation (RFA) (n=7), and resection plus RFA (n=4). Potential prognostic markers tested were maxSUV of primary tumor, maxSUV of HM, maxSUV ratio of HM over primary tumor (M/P ratio), histologic grade, CEA level, venous/lymphatic/nerve invasion, T stage, N stage, no. of HM, no. of lymph node metastasis, and treatment modality of HM.
RESULTS
14 CRC patients developed a recurrence with a median follow-up duration of 244 days, whereas 10 patients did not develop recurrence with a median follow-up duration of 504 days. M/P ratios but other potential prognostic markers were significantly higher in the recurrent patients (0.72+/-0.14) than recurrence-free patients (0.54+/-0.23) (p=0.038). M/P ratio only was found to predict recurrence by Cox multivariate analysis (hazard ratio 37.7, 95% confidence interval 2.01-706.1, p=0.016). The 11 patients with lower M/P ratio of <0.61 had significantly better disease-free survival rate than the 13 patients with higher M/P ratio (> or =0.61) (p=0.026).
CONCLUSION
maxSUV ratio of HM over primary tumor (M/P ratio) may be useful for prognosis prediction of CRC patients with HM. Higher FDG uptake of HM than that of primary tumor may indicate a more advanced status in stage IV CRC.

Keyword

Colorectal cancer; hepatic metastasis; prognosis; fluorodeoxyglucose; positron emission tomography

MeSH Terms

Colorectal Neoplasms
Disease-Free Survival
Follow-Up Studies
Humans
Lymph Nodes
Multivariate Analysis
Neoplasm Metastasis
Positron-Emission Tomography
Prognosis
Recurrence