369P - Whole-body metabolic tumor volume on F-18 FDG PET/CT as a prognostic factor in breast cancer patients with distant metastasis

Date 27 September 2014
Event ESMO 2014
Session Poster Display session
Topics Breast Cancer, Metastatic
Imaging, Diagnosis and Staging
Presenter Sang-woo Lee
Citation Annals of Oncology (2014) 25 (suppl_4): iv116-iv136. 10.1093/annonc/mdu329
Authors S. Lee1, S.H. Son1, S.Y. Jeong1, B. Song1, Y.S. Chae2, B. Ahn1, J. Lee1
  • 1Nuclear Medicine, Kyungpook National University Medical Center, 702210 - DAEGU/KR
  • 2Hematology/oncology, Kyungpook National University Medical Center, 702-210 - Daegu/KR

Abstract

Aim

This study was performed to evaluate the prognostic relevance of PET parameters measured by F-18 FDG PET/CT in invasive ductal breast cancer (IDC) patients with distant metastasis at initial diagnosis.

Methods

Forty female IDC patients with distant metastasis at initial diagnosis that underwent pretreatment F-18 FDG PET/CT were enrolled. Clinicopathologic parameters [age, TNM stage, location of metastatic lesion, estrogen receptor (ER) status, progesterone receptor (PR) status, human epidermal growth factor receptor2 (HER2) status] and metabolic PET parameters [SUVmax of the primary tumor (pSUVmax), SUVmax of axillary lymph node (nSUVmax), SUVmax of whole malignant lesions (wSUVmax), whole-body metabolic tumor volume (WBMTV), and whole-body total lesion glycolysis (WBTLG)] were analyzed with respect to the prediction of overall survival (OS). Univariate and multivariate analyses were performed to assess the prognostic significances of parameters using Kaplan-Meier and Cox proportional hazards models.

Results

Twenty of the 40 patients (50 %) died during follow-up (mean, 34.7 months; range, 0.8–71.4 months). Non-survivors had a significantly higher mean WBMTV than survivors (444.7 ± 695.0 cm3, vs. 88.0 ± 95.4 cm3, p = 0.0287). Receiver-operating-characteristic analysis showed that a WBMTV of 167.8 cm3 (sensitivity, 50.0 %; specificity, 90.0 %; area under the curve, 0.670) was an optimal cutoff for predicting OS. T stage, location of metastatic lesion, ER status, PR status, wSUVmax, WBMTV, and WBTLG were found to be prognostic factors of OS by univariate analysis, but age, N stage, pSUVmax, nSUVmax, and HER2 status were not. Multivariate analysis revealed only WBMTV independently predicted OS (HR, 4.70; 95 % CI, 1.33–16.56; p = 0.0165).

Conclusions

WBMTV on pretreatment F-18 FDG PET/CT was found to be an independent prognostic factor of OS in invasive ductal breast cancer patients with distant metastasis at initial diagnosis.

Disclosure

All authors have declared no conflicts of interest.