Is there utility for fluorine-18-fluorodeoxyglucose positron-emission tomography scan before surgery in breast cancer? A 15-year overall survival analysis  

作　　者：Justine Perrin Karim Farid Hilde Van Parijs Olena Gorobets Vincent Vinh-Hung Nam P Nguyen Navid Djassemi Mark De Ridder Hendrik Everaert 

机构地区：[1]Nuclear Medicine,CHU de Martinique,Fort-de-France 97200,Martinique [2]Department of Radiotherapy,UZ Brussel,Brussels 1090,Belgium [3]Head and Neck Surgery,CHU de Martinique,Fort-de-France 97200,Martinique [4]Department of Radiotherapie,Centre Hospitalier de Polynesie française,Papeete 98713,Tahiti,French Polynesia [5]Department of Radiation Oncology,Howard University,Washington,DC 20060,United States [6]Department of Pediatry,Hackensack University Medical Center,Hackensack,NJ 07601,United States [7]Rady Children's Hospital,University of California San Diego,San Diego,CA 92123,United States [8]Department of Nuclear Medicine,UZ Brussel,Brussels 1090,Belgium

出　　处：《World Journal of Clinical Oncology》2022年第4期287-302,共16页世界临床肿瘤学杂志（英文版）

摘　　要：BACKGROUND The prognostic value of preoperative fluorine-18-fluorodeoxyglucose positronemission tomography(18 F-FDG PET)scan for determining overall survival(OS)in breast cancer(BC)patients is controversial.AIM To evaluate the OS predictive value of preoperative PET positivity after 15 years.METHODS We performed a retrospective search of the Universitair Ziekenhuis Brussel patient database for nonmetastatic patients who underwent preoperative PET between 2002-2008.PET positivity was determined by anatomical region of interest(AROI)findings for breast and axillary,sternal,and distant sites.The prognostic role of PET was examined as a qualitative binary factor(positive vs negative status)and as a continuous variable[maximum standard uptake value(SUVmax)]in multivariate survival analyses using Cox proportional hazards models.Among the 104 identified patients who received PET,36 were further analyzed for the SUVmax in the AROI.RESULTS Poor OS within the 15-year study period was predicted by PET-positive status for axillary(P=0.033),sternal(P=0.033),and combined PET-axillary/sternal(P=0.008)nodes.Poor disease-free survival was associated with PET-positive axillary status(P=0.040)and combined axillary/sternal status(P=0.023).Cox models confirmed the long-term prognostic value of combined PETaxillary/sternal status[hazard ratio(HR):3.08,95%confidence interval:1.42-6.69].SUVmax of ipsilateral breast and axilla as continuous covariates were significant predictors of long-term OS with HRs of 1.25(P=0.048)and 1.54(P=0.029),corresponding to relative increase in the risk of death of 25%and 54%per SUVmax unit,respectively.In addition,the ratio of the ipsilateral axillary SUVmax over the contralateral axillary SUVmax was the most significant OS predictor(P=0.027),with 1.94 HR,indicating a two-fold relative increase of mortality risk.CONCLUSION Preoperative PET is valuable for prediction of long-term survival.Ipsilateral axillary SUVmax ratio over the uninvolved side represents a new prognostic finding that warrants further inve

关 键 词：Restricted mean survival time Long-term prognosis Overall survival Preoperative workup Breast surgery Positron-emission tomography scan 

分 类 号：R737.9[医药卫生—肿瘤]