| Title | Elevated tumor-to-liver standardized uptake value ratio (TLR) from preoperative F-18-FDG PET/CT predicts poor prognosis of patients with clear cell renal cell carcinoma after nephrectomy |
| Authors | Wu, Caixia Cui, Yonggang Zhao, Yanyan Chen, Xueqi Liao, Xuhe Di, Lijuan Yin, Lei Liu, Meng Wang, Rongfu |
| Affiliation | Peking Univ First Hosp, Dept Nucl Med, 8 Xishiku St, Beijing 100034, Peoples R China |
| Keywords | TOTAL LESION GLYCOLYSIS GRADING SYSTEM FDG PET/CT SURVIVAL CLASSIFICATION SOCIETY VOLUME |
| Issue Date | Oct-2020 |
| Publisher | EUROPEAN JOURNAL OF RADIOLOGY |
| Abstract | Aim: To assess the potential of using preoperative F-18-FDG PET/CT to predict the prognosis of patients with clear cell renal cell carcinoma (ccRCC) after nephrectomy. Methods: Sixty-nine patients with newly diagnosed ccRCC who underwent F-18-FDG PET/CT prior to surgery were retrospectively reviewed. The metabolic parameters of maximum standardized uptake value (SUVmax) and tumor-to-liver ratio (TLR) from F-18-FDG PET/CT were obtained. Clinicopathological characteristics, including the World Health Organization/the International Society of Urological Pathology (WHO/ISUP) grade, pathological tumor node metastasis (pTNM) stage, venous tumor thrombus, and so on, were acquired. Univariate and multivariate Cox proportional hazards analyses were performed to identify the prognostic factors for disease-free survival (DFS). Results: Of the 69 patients, 25 patients (36.2%) experienced disease progression during the follow-up period. In univariate analysis, the primary tumor size (>4.85 cm), pTNM stage (III/IV), WHO/ISUP grade (G3/4), venous tumor thrombus, adjuvant therapy, SUVmax (>3.55), and TLR (>1.66) were found to correlate with the incidence of decreased DFS (P < 0.05). In multivariate analysis, TLR (P = 0.007, HR: 5.489, 95%CI: 1.605-18.774) and pTNM stage (P = 0.024, HR: 10.385, 95%CI: 1.361-79.238) were revealed to serve as independent prognostic predictors for DFS after adjustment for other variables. Only 3 cases (8.3%) with normal TLR showed disease progression, while 22 cases (66.7%) with elevated TLR experienced disease progression. Conclusion: ccRCC patients with preoperatively elevated TLR (>1.66) and high pTNM stages (III/IV) had significantly unfavorable survival outcomes. These patients should be carefully monitored to detect the possibility of disease progression after nephrectomy as early as possible. |
| URI | http://hdl.handle.net/20.500.11897/621660 |
| ISSN | 0720-048X |
| DOI | 10.1016/j.ejrad.2020.109218 |
| Indexed | SCI(E) |
| Appears in Collections: | 第一医院 |
