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Metabolic activity measured on PET/CT correlates with clinical outcomes in patients with limb and girdle sarcomas
Author(s) -
Skamene Sonia R.,
Rakheja Rajan,
Dalhstrom Kristina R.,
Roberge David,
Nahal Ayoub,
Charest Mathieu,
Turcotte Robert,
Hickeson Marc,
Freeman Carolyn
Publication year - 2014
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.23523
Subject(s) - medicine , hazard ratio , standardized uptake value , soft tissue , sarcoma , confidence interval , proportional hazards model , surgery , nuclear medicine , positron emission tomography , pathology
Abstract Objective To explore the relationship between metabolic activity and outcome in patients with extremity sarcomas. Methods Between June 2004 and December 2011, 120 patients with newly diagnosed limb and girdle sarcomas underwent FDG‐PET/CT for disease staging prior to curative intent treatment. The maximum standardized uptake value (SUV max ) was measured for each primary tumor and correlated with outcome. Progression‐free survival and overall survival (OS) were analyzed using the Kaplan–Meier method. Results Soft‐tissue sarcomas were more frequent (68%) than bone (27%) or cartilage (5%) tumors. Median follow‐up was 33.2 months. 51% of patients progressed during the follow‐up interval and 38% died. SUV max was dichotomized with a cut‐point of 10.3. Patients with SUV max < 10.3 had better DFS and OS compared with patients with SUV max ≥ 10.3 ( P < 0.001 and P < 0.001, respectively [log‐rank test]). Multivariate analysis confirmed that even after adjusting for age, sex, site, tumor type (bone vs. soft‐tissue), grade, and stage; an SUV max ≥ 10.3 correlated with a twofold risk of progression and 2.4 times greater risk of death (hazard ratio [HR] 2.0, 95% CI, 1.1–3.7, and HR, 2.4, 95% CI, 1.1–4.9). Conclusion SUV max is an independent adverse prognostic factor for both progression and OS in patients with extremity sarcomas. J. Surg. Oncol. 2014 109:410–414 . © 2013 Wiley Periodicals, Inc.