The Added-value of Staging ¹⁸F-FDG PET/CT in the Prediction of Overall Survival in the Patients with Bladder Cancer.

IF 0.9 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Molecular Imaging and Radionuclide Therapy Pub Date : 2024-02-22 DOI:10.4274/mirt.galenos.2023.65002

Seda Gülbahar Ateş, Bedriye Büşra Demirel, Halil Başar, Gülin Uçmak

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Abstract

Objectives: This retrospective study aimed to evaluate the prognostic importance of ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG)-positive pelvic lymph nodes (LNs) and extra-pelvic disease on staging ¹⁸F-FDG positron emission tomography/computed tomography (PET/CT) in patients with bladder cancer.

Methods: Bladder cancer patients who underwent staging ¹⁸F-FDG PET/CT were included in the study. Histopathologic features of tumors, therapy histories, presence of distinguishable tumors on CT and PET images, sizes and maximum standardized uptake value (SUV_max) of primary tumors, total numbers, sizes, and SUV_max of ¹⁸F-FDG-positive pelvic and extra-pelvic LNs, and total numbers and SUV_max of distant metastases (M1a/1b) were recorded. Patients were followed up until death or the last medical visit. Factors predicting overall survival were determined using Cox regression analysis.

Results: Fifty-five patients [median age: 70 (53-84), 48 (87.3%) male, 7 (12.7%) female] with bladder cancer were included in this study. Twenty-nine (52.7%) patients had ¹⁸F-FDG positive pelvic LNs, while 24 (43.7%) patients had ¹⁸F-FDG positive extra-pelvic disease. Patients with ¹⁸F-FDGpositive pelvic LNs had a higher rate of extra-pelvic disease (p=0.003). The median follow-up duration was 13.5 months. The median overall survival was 16.3 months [95% confidence interval (CI) 8.9-23.7]. The primary tumor distinguishability on PET (p=0.011) and CT (p=0.009) images, the presence of ¹⁸F-FDG-positive pelvic LNs (p<0.001) and ¹⁸F-FDG-positive extra-pelvic disease/distant metastases (M1a/M1b) (p<0.001), and the number of distant metastases (p=0.034) were associated with mortality. The ¹⁸F-FDG-positive extra-pelvic disease/distant metastases [p=0.029, odds ratio: 4.15 (95% CI 1.16-14.86)] was found to be an independent predictor of mortality in patients with bladder cancer.

Conclusion: The presence of ¹⁸F-FDG-positive extra-pelvic disease in pretreatment ¹⁸F-FDG PET/CT is an important prognostic factor in bladder cancer patients.

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分期 18F-FDG PET/CT 在预测膀胱癌患者总生存期中的附加值

研究目的这项回顾性研究旨在评估18F-氟脱氧葡萄糖（18F-FDG）阳性盆腔淋巴结（LN）和盆腔外疾病对膀胱癌患者分期18F-FDG正电子发射断层扫描/计算机断层扫描（PET/CT）预后的重要性：研究对象包括接受分期 18F-FDG PET/CT 检查的膀胱癌患者。记录肿瘤的组织病理学特征、治疗史、CT 和 PET 图像上可分辨的肿瘤、原发肿瘤的大小和最大标准化摄取值（SUVmax）、18F-FDG 阳性盆腔和盆腔外 LN 的总数、大小和 SUVmax，以及远处转移灶（M1a/1b）的总数和 SUVmax。对患者进行随访，直至死亡或最后一次就诊。采用Cox回归分析确定预测总生存率的因素：本研究共纳入55名膀胱癌患者[中位年龄：70（53-84）岁，48（87.3%）名男性，7（12.7%）名女性]。29例（52.7%）患者的盆腔LN呈18F-FDG阳性，24例（43.7%）患者的盆腔外疾病呈18F-FDG阳性。18F-FDG 阳性盆腔 LN 患者的盆腔外疾病发生率更高（P=0.003）。中位随访时间为13.5个月。中位总生存期为 16.3 个月[95% 置信区间 (CI) 8.9-23.7]。PET（p=0.011）和CT（p=0.009）图像上的原发肿瘤可分辨性、18F-FDG阳性盆腔LN（p18F-FDG阳性盆腔外疾病/远处转移灶（M1a/M1b）（p18F-FDG阳性盆腔外疾病/远处转移灶 [p=0.029, odds ratio: 4.15 (95% CI 1.16-14.86)] 是膀胱癌患者死亡率的独立预测因素：结论：治疗前 18F-FDG PET/CT 中出现 18F-FDG 阳性的盆腔外疾病是膀胱癌患者的一个重要预后因素。

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Molecular Imaging and Radionuclide Therapy RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-

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1.30

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0.00%

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期刊介绍： Molecular Imaging and Radionuclide Therapy (Mol Imaging Radionucl Ther, MIRT) is publishes original research articles, invited reviews, editorials, short communications, letters, consensus statements, guidelines and case reports with a literature review on the topic, in the field of molecular imaging, multimodality imaging, nuclear medicine, radionuclide therapy, radiopharmacy, medical physics, dosimetry and radiobiology.