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Annals of Nuclear Medicine

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01-02-2014 | Original Article

Metabolic information on staging FDG-PET–CT as a prognostic tool in the evaluation of 97 patients with gastric cancer

Authors: Nicholas A. Coupe, Deme Karikios, Shanley Chong, June Yap, Weng Ng, Neil Merrett, Michael Lin

Published in: Annals of Nuclear Medicine | Issue 2/2014

Abstract

Background and objective

Gastric cancer remains a leading cause of malignancy-related mortality. Many patients with locally advanced disease succumb despite peri-operative chemotherapy and the survival benefit of chemotherapy for advanced disease is modest, suggesting that current staging is imperfect. The role of fluorine-18-2-fluoro-2-deoxy-d-glucose positron emission tomography (FDG-PET) in the staging of gastric cancer remains to be determined. This study aimed to determine, and compare with computerized tomography (CT), the association between FDG-PET uptake in the primary tumour and regional lymph nodes, and overall survival in patients with all stage gastric cancer.

Methods

Patients with histologically confirmed gastric cancer (any stage) who, at diagnosis, had received a staging FDG-PET–CT at our institution between 2006 and 2011 were included. Records were retrospectively analysed. Patients with >50 % of tumour above the gastro-oesophageal junction or an active second malignancy were excluded.

Results

97 patients were included in the analysis. Surgery with curative intent was performed in 68 patients. In univariate analysis, an association with overall survival was seen in patients who had FDG-PET-positive primary tumours (hazard ratio (HR) for death 3.33, 95 % confidence interval (95 % CI) 1.63–6.80, p = 0.001). FDG-PET lymph node positive (vs node negativity) was associated with inferior overall survival (HR 8.66, 95 % CI 4.59–16.37, p < 0.0001), and remained an independent predictor in the multivariate analysis. In contrast, positive lymphadenopathy identified on CT was not associated with overall survival (HR 1.34, 95 % CI 0.79–2.29, p = 0.82).

Conclusion

FDG-PET-positive tumours are associated with an inferior overall survival. In contrast to CT, FDG-PET-positive lymphadenopathy is associated with a decreased overall survival.

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Title: Metabolic information on staging FDG-PET–CT as a prognostic tool in the evaluation of 97 patients with gastric cancer
Authors: Nicholas A. Coupe
Deme Karikios
Shanley Chong
June Yap
Weng Ng
Neil Merrett
Michael Lin
Publication date: 01-02-2014
Publisher: Springer Japan
Published in: Annals of Nuclear Medicine / Issue 2/2014
Print ISSN: 0914-7187
Electronic ISSN: 1864-6433
DOI: https://doi.org/10.1007/s12149-013-0791-8

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Metabolic information on staging FDG-PET–CT as a prognostic tool in the evaluation of 97 patients with gastric cancer

Abstract

Background and objective

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background and objective

Methods

Results

Conclusion

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