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Standardized uptake value by positron emission tomography/computed tomography as a prognostic variable in metastatic breast cancer
Author(s) -
Morris Patrick G.,
Ulaner Gary A.,
Eaton Anne,
Fazio Maurizio,
Jhaveri Komal,
Patil Sujata,
Evangelista Laura,
Park Joseph Y.,
SernaTamayo Cristian,
Howard Jane,
Larson Steven,
Hudis Clifford A.,
McArthur Heather L.,
Jochelson Maxine S.
Publication year - 2012
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.27579
Subject(s) - medicine , hazard ratio , confidence interval , breast cancer , metastatic breast cancer , nuclear medicine , positron emission tomography , standardized uptake value , proportional hazards model , univariate analysis , retrospective cohort study , radiology , cancer , multivariate analysis
BACKGROUND: In this retrospective, single‐institution study, the authors examine the maximum standardized uptake value (SUVmax) on positron emission tomography/computed tomography (PET/CT) images as a prognostic variable in patients with newly diagnosed metastatic breast cancer (MBC). METHODS: Patients with ≥1 metastatic lesion on PET/CT images that were obtained within 60 days of their MBC diagnosis between January 1, 2001 and December 31, 2008 were included. Patients were excluded if they had received chemotherapy ≤30 days before the PET/CT images were obtained. Electronic medical reports were reviewed to determine the SUVmax and overall survival. Because of intraindividual variation in the SUV by body site, separate analyses were conducted by metastatic site. Relationships between site‐specific PET/CT variable tertiles and overall survival were assessed using Cox regression; hazard ratios for the highest tertile versus the lowest tertile were reported. RESULTS: In total, 253 patients were identified, and their median age was 57 years (range, 27‐90 years). Of these, 152 patients (60%) died, and the median follow‐up was 40 months. On univariate analysis, SUVmax tertile was strongly associated with overall survival in patients who had bone metastases (N = 141; hazard ratio, 3.13; 95% confidence interval, 1.79‐5.48; P < .001). This effect was maintained on multivariate analysis (HR = 3.19; 95% confidence interval, 1.64‐6.20, P = .002) after correcting for known prognostic variables. A greater risk of death was associated with SUVmax tertile in patients who had metastases to the liver (N = 46; hazard ratio, 2.07; 95% confidence interval, 0.90‐4.76), lymph nodes (N = 149; hazard ratio, 1.1; 95% confidence interval, 0.69‐1.88), and lung (N = 62; hazard ratio, 2.2; 95% confidence interval, 0.97‐4.95), although these results were not significant ( P = .18, P = .31, and P = .095, respectively). CONCLUSIONS: The current results indicate that PET/CT has value as a prognostic tool in patients with newly diagnosed MBC to bone. Cancer 2012. © 2012 American Cancer Society.