Abstract

Abstract Background: Glucose utilisation of visceral adipose tissue (VAT) reflects inflammatory activities, which promote tumour cell growth and carcinogenesis. The impact of the VAT-inflammatory response on survival outcomes in breast cancer is not known. We investigated survival outcomes in breast cancer patients based on the standardised uptake value (SUV) in VAT using 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET/CT). Methods: We retrospectively enrolled breast cancer patients (stages I-III) treated at the Gangnam Severance Hospital between 2007 and 2010. Metabolic activities of VAT and tumour were calculated based on FDG uptake, and the clinical characteristics and survival outcomes were comparatively analysed in the high-SUV and low-SUV groups. Results: The SUV of VAT (SUV-VAT) was obtained for 148 patients. With no significant intergroup differences in clinical characteristics, high SUV-VAT was associated with poor recurrence-free survival (RFS; hazard ratio [HR] 2.754, 95% confidence interval [CI] 1.090-6.958, P=0.032) and distant metastasis-free survival (DMFS; HR 3.500, 95% CI 1.224-10.01, P=0.019). Multivariate analysis showed that high SUV-VAT was a significant clinical factor for both poor RFS and DMFS (P=0.023 and P=0.039, respectively). SUV-tumour was significantly associated with RFS (P=0.0388), but not DMFS (P=0.0718). Conclusion: The glucose metabolism of VAT, assessed by 18F-FDG PET/CT, is a prognostic biomarker of adverse outcomes and of primary tumour metabolism in breast cancer. The glucose utilisation of VAT may reflect the degree of inflammation associated with breast cancer recurrence and metastasis. Keywords: breast cancer, visceral adipose tissue, inflammation, 18F-FDG, PET/CT, glycolysis, metastasis, recurrence Citation Format: Pill Sun Paik, Chang Ik Yoon, Hyun Jeong Kim, Yoon Jin Cha, Dooreh Kim, Soong June Bae, Sung Gwe Ahn, Joon Jeong, Woo-Chan Park, Young Hoon Ryu, Tae Joo Jeon, Chai Won Kim. 18F-FDG uptake of visceral adipose tissue on preoperative PET/CT as a predictive marker for breast cancer recurrence [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P4-05-08.

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