The prognostic value of volume-based parameters using 18F-FDG PET/CT in gastric cancer according to HER2 status

Ji Soo Park; Nare Lee; Seung Hoon Beom; Hyo Song Kim; Choong kun Lee; Sun Young Rha; Hyun Cheol Chung; Mijin Yun; Arthur Cho; Minkyu Jung

doi:10.1007/s10120-017-0739-0

The prognostic value of volume-based parameters using ¹⁸F-FDG PET/CT in gastric cancer according to HER2 status

Ji Soo Park, Nare Lee, Seung Hoon Beom, Hyo Song Kim, Choong kun Lee, Sun Young Rha, Hyun Cheol Chung, Mijin Yun, Arthur Cho, Minkyu Jung

Department of Internal Medicine

Research output: Contribution to journal › Article › peer-review

24 Citations (Scopus)

Abstract

Background: We aimed to find the clinical value of metastatic tumor burden evaluated with F18-FDG PET/CT in gastric cancer patients, considering the human epidermal growth factor receptor 2 (HER2) status. Methods: We retrospectively reviewed 124 patients with locally advanced or metastatic gastric cancer at Yonsei Cancer Center between January 2006 and December 2014 who had undergone baseline FDG PET/CT before first-line chemotherapy. We measured the maximum standardized uptake value from the primary tumor (SUV_max) and whole-body (WB) PET/CT parameters, including WB SUV_max, WB SUV_mean, WB metabolic tumor volume (WB MTV), and WB total lesion glycolysis (WB TLG), in all metabolically active metastatic lesions (SUV threshold ≥2.5 or 40% isocontour for ≤2.5), and we determined their association with patient survival outcomes. Results: SUV_max was higher in HER2-positive gastric cancers (median 12.1, range 3.4–34.6) compared to HER-2 negative (7.4, 1.6–39.1, P OpenSPiltSPi 0.001). Among all patients, WB TLG CloseSPigtSPi 600, which is indicative of a high metastatic tumor burden, showed worse progression-free survival (PFS) [hazard ratio (HR), 2.003; 95% CI, 1.300–3.086; P = 0.002] and overall survival (OS) (HR, 3.001; 95% CI, 1.950–4.618; P OpenSPiltSPi 0.001) than did WB TLG ≤ 600. Among HER2-positive gastric cancer patients treated with trastuzumab, higher metabolic tumor burden predicted worse OS, but not PFS. Conclusions: HER2-positive gastric cancers had higher SUV_max compared to HER2-negative gastric cancers. In both HER2-negative patients and -positive patients receiving trastuzumab, FDG PET/CT volume-based parameters may have a role in further stratifying the prognosis of stage IV gastric cancer.

Original language	English
Pages (from-to)	213-224
Number of pages	12
Journal	Gastric Cancer
Volume	21
Issue number	2
DOIs	https://doi.org/10.1007/s10120-017-0739-0
Publication status	Published - 2018 Mar 1

Bibliographical note

Funding Information:
Acknowledgements This research was supported by Yonsei University Future-leading Research Initiative of 2014 (2014-22-0151 by Minkyu Jung). The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Publisher Copyright:
© 2017, The International Gastric Cancer Association and The Japanese Gastric Cancer Association.

All Science Journal Classification (ASJC) codes

Oncology
Gastroenterology
Cancer Research

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1007/s10120-017-0739-0

Cite this

@article{f1b0b5dc3a574990a1dd92ae10f78d4f,

title = "The prognostic value of volume-based parameters using 18F-FDG PET/CT in gastric cancer according to HER2 status",

abstract = "Background: We aimed to find the clinical value of metastatic tumor burden evaluated with F18-FDG PET/CT in gastric cancer patients, considering the human epidermal growth factor receptor 2 (HER2) status. Methods: We retrospectively reviewed 124 patients with locally advanced or metastatic gastric cancer at Yonsei Cancer Center between January 2006 and December 2014 who had undergone baseline FDG PET/CT before first-line chemotherapy. We measured the maximum standardized uptake value from the primary tumor (SUVmax) and whole-body (WB) PET/CT parameters, including WB SUVmax, WB SUVmean, WB metabolic tumor volume (WB MTV), and WB total lesion glycolysis (WB TLG), in all metabolically active metastatic lesions (SUV threshold ≥2.5 or 40% isocontour for ≤2.5), and we determined their association with patient survival outcomes. Results: SUVmax was higher in HER2-positive gastric cancers (median 12.1, range 3.4–34.6) compared to HER-2 negative (7.4, 1.6–39.1, P OpenSPiltSPi 0.001). Among all patients, WB TLG CloseSPigtSPi 600, which is indicative of a high metastatic tumor burden, showed worse progression-free survival (PFS) [hazard ratio (HR), 2.003; 95% CI, 1.300–3.086; P = 0.002] and overall survival (OS) (HR, 3.001; 95% CI, 1.950–4.618; P OpenSPiltSPi 0.001) than did WB TLG ≤ 600. Among HER2-positive gastric cancer patients treated with trastuzumab, higher metabolic tumor burden predicted worse OS, but not PFS. Conclusions: HER2-positive gastric cancers had higher SUVmax compared to HER2-negative gastric cancers. In both HER2-negative patients and -positive patients receiving trastuzumab, FDG PET/CT volume-based parameters may have a role in further stratifying the prognosis of stage IV gastric cancer.",

author = "Park, {Ji Soo} and Nare Lee and Beom, {Seung Hoon} and Kim, {Hyo Song} and Lee, {Choong kun} and Rha, {Sun Young} and Chung, {Hyun Cheol} and Mijin Yun and Arthur Cho and Minkyu Jung",

note = "Funding Information: Acknowledgements This research was supported by Yonsei University Future-leading Research Initiative of 2014 (2014-22-0151 by Minkyu Jung). The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. Publisher Copyright: {\textcopyright} 2017, The International Gastric Cancer Association and The Japanese Gastric Cancer Association.",

year = "2018",

month = mar,

day = "1",

doi = "10.1007/s10120-017-0739-0",

language = "English",

volume = "21",

pages = "213--224",

journal = "Gastric Cancer",

issn = "1436-3291",

publisher = "Springer Japan",

number = "2",

}

TY - JOUR

T1 - The prognostic value of volume-based parameters using 18F-FDG PET/CT in gastric cancer according to HER2 status

AU - Park, Ji Soo

AU - Lee, Nare

AU - Beom, Seung Hoon

AU - Kim, Hyo Song

AU - Lee, Choong kun

AU - Rha, Sun Young

AU - Chung, Hyun Cheol

AU - Yun, Mijin

AU - Cho, Arthur

AU - Jung, Minkyu

N1 - Funding Information: Acknowledgements This research was supported by Yonsei University Future-leading Research Initiative of 2014 (2014-22-0151 by Minkyu Jung). The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. Publisher Copyright: © 2017, The International Gastric Cancer Association and The Japanese Gastric Cancer Association.

PY - 2018/3/1

Y1 - 2018/3/1

N2 - Background: We aimed to find the clinical value of metastatic tumor burden evaluated with F18-FDG PET/CT in gastric cancer patients, considering the human epidermal growth factor receptor 2 (HER2) status. Methods: We retrospectively reviewed 124 patients with locally advanced or metastatic gastric cancer at Yonsei Cancer Center between January 2006 and December 2014 who had undergone baseline FDG PET/CT before first-line chemotherapy. We measured the maximum standardized uptake value from the primary tumor (SUVmax) and whole-body (WB) PET/CT parameters, including WB SUVmax, WB SUVmean, WB metabolic tumor volume (WB MTV), and WB total lesion glycolysis (WB TLG), in all metabolically active metastatic lesions (SUV threshold ≥2.5 or 40% isocontour for ≤2.5), and we determined their association with patient survival outcomes. Results: SUVmax was higher in HER2-positive gastric cancers (median 12.1, range 3.4–34.6) compared to HER-2 negative (7.4, 1.6–39.1, P OpenSPiltSPi 0.001). Among all patients, WB TLG CloseSPigtSPi 600, which is indicative of a high metastatic tumor burden, showed worse progression-free survival (PFS) [hazard ratio (HR), 2.003; 95% CI, 1.300–3.086; P = 0.002] and overall survival (OS) (HR, 3.001; 95% CI, 1.950–4.618; P OpenSPiltSPi 0.001) than did WB TLG ≤ 600. Among HER2-positive gastric cancer patients treated with trastuzumab, higher metabolic tumor burden predicted worse OS, but not PFS. Conclusions: HER2-positive gastric cancers had higher SUVmax compared to HER2-negative gastric cancers. In both HER2-negative patients and -positive patients receiving trastuzumab, FDG PET/CT volume-based parameters may have a role in further stratifying the prognosis of stage IV gastric cancer.

AB - Background: We aimed to find the clinical value of metastatic tumor burden evaluated with F18-FDG PET/CT in gastric cancer patients, considering the human epidermal growth factor receptor 2 (HER2) status. Methods: We retrospectively reviewed 124 patients with locally advanced or metastatic gastric cancer at Yonsei Cancer Center between January 2006 and December 2014 who had undergone baseline FDG PET/CT before first-line chemotherapy. We measured the maximum standardized uptake value from the primary tumor (SUVmax) and whole-body (WB) PET/CT parameters, including WB SUVmax, WB SUVmean, WB metabolic tumor volume (WB MTV), and WB total lesion glycolysis (WB TLG), in all metabolically active metastatic lesions (SUV threshold ≥2.5 or 40% isocontour for ≤2.5), and we determined their association with patient survival outcomes. Results: SUVmax was higher in HER2-positive gastric cancers (median 12.1, range 3.4–34.6) compared to HER-2 negative (7.4, 1.6–39.1, P OpenSPiltSPi 0.001). Among all patients, WB TLG CloseSPigtSPi 600, which is indicative of a high metastatic tumor burden, showed worse progression-free survival (PFS) [hazard ratio (HR), 2.003; 95% CI, 1.300–3.086; P = 0.002] and overall survival (OS) (HR, 3.001; 95% CI, 1.950–4.618; P OpenSPiltSPi 0.001) than did WB TLG ≤ 600. Among HER2-positive gastric cancer patients treated with trastuzumab, higher metabolic tumor burden predicted worse OS, but not PFS. Conclusions: HER2-positive gastric cancers had higher SUVmax compared to HER2-negative gastric cancers. In both HER2-negative patients and -positive patients receiving trastuzumab, FDG PET/CT volume-based parameters may have a role in further stratifying the prognosis of stage IV gastric cancer.

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