Open AccessBody Mass Index with Tumor 18F-FDG Uptake Improves Risk Stratification in Patients with Breast Cancer
Author(s) -
Seung Hyup Hyun,
Hee Kyung Ahn,
Joo Hee Lee,
Joon Young Choi,
ByungTae Kim,
Yeon Hee Park,
YoungHyuck Im,
Jeong Eon Lee,
Seok Jin Nam,
Kyung-Han Lee
Publication year - 2016
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0165814
Subject(s) - medicine , breast cancer , overweight , standardized uptake value , body mass index , hazard ratio , proportional hazards model , cancer , positron emission tomography , oncology , nuclear medicine , confidence interval
Purpose To investigate the combined prognostic impact of body mass index (BMI) and tumor standardized uptake value (SUV) measured on pretreatment 18 F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) in patients with breast cancer. Methods We evaluated a cohort of 332 patients with newly diagnosed breast cancer (stage I-III) who underwent pretreatment FDG PET/CT followed by curative resection. Patients were categorized as overweight (BMI ≥ 23 kg/m 2 ) or normal weight (BMI < 23 kg/m 2 ). Primary tumor maximum SUV was measured by FDG PET/CT. Associations between BMI and tumor SUV with disease recurrence were assessed using Cox regression models. Results Median follow-up was 39 months. There were 76 recurrences and 15 cancer-related deaths. Multivariable Cox regression analysis demonstrated that high tumor SUV (hazard ratio [HR] = 1.75; 95% CI, 1.02–3.02; P = 0.044) and overweight (HR = 1.84; 95% CI, 1.17–2.89; P = 0.008) were independent poor prognostic factors. Positive hormone receptor status was an independent predictor of favorable outcome (HR = 0.42; 95% CI, 0.26–0.68; P < 0.001). Overweight patients with high tumor SUV had a two-fold risk of recurrence compared to patients with normal weight or low tumor SUV after adjusting for clinical stage and tumor subtype (HR = 2.06; 95% CI, 1.30–3.27; P = 0.002). Conclusions In patients with breast cancer, higher tumor SUV was associated with a more adverse outcome particularly in overweight women. BMI status combined with tumor SUV data allows better risk-stratification of breast cancer, independent of clinical stage and tumor subtype.