Abstract
Objectives:The aim of this study was to evaluate the impact of maximum standard uptake value (SUVmax) of the primary tumor and locoregional metastatic lymph node in predicting survival in patients with the preoperative rectal adenocarcinoma.Methods:One hundred and fifteen patients [mean age ± standard deviation (SD): 58.7±11.4 years] with biopsy-proven rectal adenocarcinoma underwent 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) imaging for the staging were included in this study. All patients were followed-up for a minimum of 12 months (mean ± SD: 29.7±13.5 months). Tumor-node-metastasis 2017 clinical staging, SUVmax of the primary rectal tumor and locoregional lymph nodes on the PET/CT studies were evaluated.Results:All patients had increased FDG activity of the primary tumor. The mean ± SD SUVmax of the primary tumor and locoregional metastatic lymph node were 21.0±9.1 and 4.6±2.8, respectively. Primary tumor SUVmax did not have an effect on predicting survival (p=0.525) however locoregional metastatic lymph node SUVmax had an effect (p<0.05) on predicting survival. Clinical stage of the disease was a factor predicting survival (p<0.001).Conclusion:18F-FDG PET/CT is an effective imaging modality for detecting primary tumors and metastases in rectal adenocarcinoma and clinical stage assessment with PET/CT had an effect on predicting survival. Furthermore, in our study locoregional lymph node SUVmaks was defined as a factor in predicting survival.
Highlights
Colorectal cancer is the third most common cancer in men and the second most common in women [1]
There was no significant relation between primary tumor SUVmax and disease-free survival (DFS) or primary tumor SUVmax and overall survival (OS) (p=0.760 and p=0.525) (Table 2)
As the preoperative 18F-FDG positron emission tomography/computed tomography (PET/CT) parameters could be able to predict survival outcomes in rectal cancer, we evaluated the impact of primary tumor SUVmax on survival and it was shown that there was no correlation between primary tumor SUV
Summary
Colorectal cancer is the third most common cancer in men and the second most common in women [1]. It is one of the most important causes of cancer-related morbidity and mortality, globally [2]. The importance of clinical staging with positron emission tomography/computed tomography (PET/CT) is established [4], the effect of the maximum standard uptake value (SUVmax) acquired with 18F-fluorodeoxyglucose (FDG) PET/CT on survival in initial staging has been evaluated by several studies. The effect of metastatic locoregional lymph node FDG uptake level on survival has not been sufficiently studied. The aim of this study was to analyze the effect of the primary tumor and locoregional metastatic lymph node SUV and stage of disease detected with 18F-FDG PET/
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