Standardized uptake value of 18F-fluorodeoxyglucose positron emission tomography for prediction of tumor recurrence in breast cancer beyond tumor burden
Menée à partir de données portant sur 496 patientes atteintes d'un cancer du sein, cette étude évalue l'intérêt de mesurer, avant l'opération et à l'aide d'une tomographie par émission de positrons à base de fluorodésoxyglucose (18F), l'activité métabolique de la tumeur pour prédire la survie sans récidive
Introduction : 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) can reveal the metabolic activity of malignant tumors. Recent advances in molecular works suggest that tumor biology can well predict prognosis in breast cancer. We compared the ability of maximum standardized uptake values (SUVmax) from FDG-PET with tumor burden in predicting tumor recurrence for patients with breast cancer.
Methods : Between April 2004 and May 2009, 496 breast cancer patients who underwent pre-operative FDG-PET were retrospectively identified. SUVmax was obtained from FDG-PET, and the cut-off point was defined using a time-dependent receiver operator characteristic curve for recurrence-free survival (RFS). The primary end-point was RFS.
Results : In multivariate analysis for RFS, SUVmax carried independent prognostic significance (P?=?0.012, hazard ratio (HR) 2.39, 95% confidence interval (CI) 1.20 to 4.76). When the patients were classified into four groups according to the combined factor of tumor size (?2?cm versus >2?cm) and SUVmax (<4 versus ?4), RFS differed significantly (P <0.001). Similarly, SUVmax had prognostic value in combination with nodal status (negative versus positive) or stage (I versus II and III) (P <0.001 and P?=?0.001, respectively). In hormone receptor-positive disease, SUVmax remained a significant prognostic factor for RFS based on multivariate analysis.
Conclusions : Our results highlight the prognostic value of FDG-PET in prediction of tumor relapse for breast cancer patients. Particularly in hormone receptor-positive disease, the tumor metabolic information provided by FDG-PET is more significantly correlated with prognosis than tumor burden.
Breast Cancer Research , article en libre accès, 2013