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Prognostic value of FDG PET/CT in liver transplantation for hepatocarcinoma
DETRY, Olivier; Govaerts, L; BLETARD, Noëlla et al.
2014In Acta Gastro-Enterologica Belgica, 77 (1), p. 08
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Keywords :
organ transplantation; liver cancer; hepatocarcinoma
Abstract :
[en] AIM : FDG uptake has been shown to predict the outcome in large series of patients with hepatocarcinoma (HCC) in Asia, but few data are available regarding European populations. Our aim was to evaluate the prognostic value of pretreatment FDG PET-CT in patients treated by liver transplantation. Methods: We retrospectively analyzed the data of 27 patients (24 M and 3 W, mean age 58 ± 9 years). The mean follow-up was 26 ± 18 months (min 1 month, max 66 months). All patients had an FDG PET-CT before the transplantation. The FDG PET/CT was performed according to a standard clinical protocol: 4 MBqFDG/kg body weight, uptake 60 min., low-dose non-enhanced CT. We measured the SUVmax and SUVmean of the tumor and the normal liver. The tumor/liver activity ratios (RSUVmax and RSUVmean) were tested as prognostic factors and compared to the following conventional prognostic factors: MILAN, CLIP, OKUDA, TNM stage, alphafoetoprotein level, portal thrombosis, size of the largest nodule, tumor differentiation, microvascular invasion, underlying cirrhosis and liver function. Results : The DFS was 87.2% at 1y and 72.1% at 3y. The OS was 85.2% at 1y and 80.7% at 3y. According to an univariate Cox model, RSUVmax, RSUVmean and healthy liver were predictors of DFS and RSUVmax, RSUVmean, size of the largest nodule, CLIP, liver involvement>50%, and healthy liver predicted the OS. According to a multivariate Cox model, only RSUVmax predicted DFS and RSUVmax and liver involvement>50% predicted OS. An ROC analysis of the ratios showed that the 1.15 cut-off for RSUVmax was best for predicting both the DFS (Cox regression:HR 14.4, p=0.02) and OS (HR 5.6, p=0.049). The Kaplan-Meier curves and Logrank tests confirmed those results. Even though the MILAN criteria alone were not predictive, it is worth noting that none of the patients outside the MILAN criteria and with RSUVmax<1.15 relapsed. Conclusions: The RSUVmax is a strong prognostic factor for recurrence and death in patients with HCC treated by liver transplantation with a cut-off value of 1,15. further prospective studies should test whether the metabolic index should be systematically included in the preoperative assessment.
Disciplines :
Surgery
Oncology
Gastroenterology & hepatology
Author, co-author :
DETRY, Olivier  ;  Centre Hospitalier Universitaire de Liège - CHU > Chirurgie abdominale- endocrinienne et de transplantation
Govaerts, L
BLETARD, Noëlla ;  Centre Hospitalier Universitaire de Liège - CHU > Anatomie pathologique
MEURISSE, Nicolas ;  Centre Hospitalier Universitaire de Liège - CHU > Chirurgie abdominale- endocrinienne et de transplantation
Verset, G
DE ROOVER, Arnaud ;  Centre Hospitalier Universitaire de Liège - CHU > Chirurgie abdominale- endocrinienne et de transplantation
DELWAIDE, Jean ;  Centre Hospitalier Universitaire de Liège - CHU > Gastro-Entérologie-Hépatologie
LAMPROYE, Anne ;  Centre Hospitalier Universitaire de Liège - CHU > Gastro-Entérologie-Hépatologie
HONORE, Pierre ;  Centre Hospitalier Universitaire de Liège - CHU > Chirurgie abdominale- endocrinienne et de transplantation
HUSTINX, Roland  ;  Centre Hospitalier Universitaire de Liège - CHU > Médecine nucléaire et imagerie oncologique
Language :
English
Title :
Prognostic value of FDG PET/CT in liver transplantation for hepatocarcinoma
Publication date :
March 2014
Event name :
XXVI Belgian Week of Gastroenterology
Event organizer :
Sociéte Royale Belge de Gastroentérologie
Event place :
La Hulpe, Belgium
Event date :
du 12 au 15 février 2014
Journal title :
Acta Gastro-Enterologica Belgica
ISSN :
0001-5644
eISSN :
1784-3227
Publisher :
Acta Medica Belgica, Bruxelles, Belgium
Volume :
77
Issue :
1
Pages :
D08
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 26 April 2014

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