Prospective evaluation of changes in tumor size and tumor metabolism in patients with advanced gastric cancer undergoing chemotherapy: Association and clinical implication

Seongyeol Park; Seunggyun Ha; Hyun Woo Kwon; Woo Hyoung Kim; Tae Yong Kim; Do Youn Oh; Gi Jeong Cheon; Yung Jue Bang

doi:10.2967/jnumed.116.182675

Prospective evaluation of changes in tumor size and tumor metabolism in patients with advanced gastric cancer undergoing chemotherapy: Association and clinical implication

Seongyeol Park, Seunggyun Ha, Hyun Woo Kwon, Woo Hyoung Kim, Tae Yong Kim, Do Youn Oh, Gi Jeong Cheon, Yung Jue Bang

Seoul National University

Research output: Contribution to journal › Article › peer-review

27 Scopus citations

Abstract

chemotherapy remains unclear. We aimed to evaluate response of tumor size and metabolism in AGC during chemotherapy and to reveal the relationship between them in view of their impact on patient survival. Methods: We prospectively enrolled patients with AGC before the initiation of first-line palliative chemotherapy. Using baseline and follow-up contrast-enhanced CT and ¹⁸F-FDG PET, we assessed the tumor diameter, SUVmax, and total lesion glycolysis in each lesion and their changes during chemotherapy at the same time. We included all lesions with the maximal longest diameters over 1 cm on CT, and each lesion was evaluated by matched ¹⁸F-FDG PET. We analyzed the association between changes in tumor metabolism and tumor size and performed outcome analysis on overall survival (OS) and progression-free survival (PFS). Results: Seventy-four patients were enrolled, and the number of all lesions included in this study was 620. Compared with adenocarcinomas, poorly cohesive carcinomas demonstrated lower SUVmax irrespective of tumor size (P , 0.001). Human epidermal growth factor receptor 2 (HER2)-positive tumors showed higher SUVmax than HER2-negative tumors (P 5 0.002). The changes in SUVmax due to chemotherapy had a linear correlation with the changes in tumor size of each lesion, and a 30% tumor size reduction was associated with a 50% SUVmax reduction (P , 0.001). Total lesion glycolysis changes also correlated with tumor size changes (P , 0.001). Better OS and PFS were obtained in patients with both tumor size and SUVmax reduction than in patients with either size or SUVmax reduction only (OS, P 5 0.003; PFS, P 5 0.038). Conclusion: Changes in tumor metabolism induced by chemotherapy correlated with changes in tumor size in AGC. Considering both changes in metabolism and size could help predict a more accurate prognosis for AGC patients undergoing chemotherapy.

Original language	English
Pages (from-to)	899-904
Number of pages	6
Journal	Journal of Nuclear Medicine
Volume	58
Issue number	6
DOIs	https://doi.org/10.2967/jnumed.116.182675
State	Published - 1 Jun 2017

Bibliographical note

Funding Information:
DiSCLOSURE This study was supported by Seoul National University Hospital Research Fund (grant 25-2014-0140) to Dr. Do-Youn Oh and by a grant from the Korea Health Technology RandD Project through the Korea Health Industry Development Institute (KHIDi), funded by the Ministry of Health & Welfare, Republic of Korea (grant HI14C1072) to Gi Jeong Cheon. No other potential conflict of interest relevant to this article was reported.

Publisher Copyright:
© 2017 by the Society of Nuclear Medicine and Molecular Imaging.

Keywords

Chemotherapy
Metabolism
Positron-emission tomography
Prognosis
Stomach neoplasm

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.2967/jnumed.116.182675

Cite this

@article{7a4dee6ee7d54bf4b6c5805f1c910c41,

title = "Prospective evaluation of changes in tumor size and tumor metabolism in patients with advanced gastric cancer undergoing chemotherapy: Association and clinical implication",

abstract = "chemotherapy remains unclear. We aimed to evaluate response of tumor size and metabolism in AGC during chemotherapy and to reveal the relationship between them in view of their impact on patient survival. Methods: We prospectively enrolled patients with AGC before the initiation of first-line palliative chemotherapy. Using baseline and follow-up contrast-enhanced CT and 18F-FDG PET, we assessed the tumor diameter, SUVmax, and total lesion glycolysis in each lesion and their changes during chemotherapy at the same time. We included all lesions with the maximal longest diameters over 1 cm on CT, and each lesion was evaluated by matched 18F-FDG PET. We analyzed the association between changes in tumor metabolism and tumor size and performed outcome analysis on overall survival (OS) and progression-free survival (PFS). Results: Seventy-four patients were enrolled, and the number of all lesions included in this study was 620. Compared with adenocarcinomas, poorly cohesive carcinomas demonstrated lower SUVmax irrespective of tumor size (P , 0.001). Human epidermal growth factor receptor 2 (HER2)-positive tumors showed higher SUVmax than HER2-negative tumors (P 5 0.002). The changes in SUVmax due to chemotherapy had a linear correlation with the changes in tumor size of each lesion, and a 30% tumor size reduction was associated with a 50% SUVmax reduction (P , 0.001). Total lesion glycolysis changes also correlated with tumor size changes (P , 0.001). Better OS and PFS were obtained in patients with both tumor size and SUVmax reduction than in patients with either size or SUVmax reduction only (OS, P 5 0.003; PFS, P 5 0.038). Conclusion: Changes in tumor metabolism induced by chemotherapy correlated with changes in tumor size in AGC. Considering both changes in metabolism and size could help predict a more accurate prognosis for AGC patients undergoing chemotherapy.",

keywords = "Chemotherapy, Metabolism, Positron-emission tomography, Prognosis, Stomach neoplasm",

author = "Seongyeol Park and Seunggyun Ha and Kwon, {Hyun Woo} and Kim, {Woo Hyoung} and Kim, {Tae Yong} and Oh, {Do Youn} and Cheon, {Gi Jeong} and Bang, {Yung Jue}",

note = "Funding Information: DiSCLOSURE This study was supported by Seoul National University Hospital Research Fund (grant 25-2014-0140) to Dr. Do-Youn Oh and by a grant from the Korea Health Technology RandD Project through the Korea Health Industry Development Institute (KHIDi), funded by the Ministry of Health & Welfare, Republic of Korea (grant HI14C1072) to Gi Jeong Cheon. No other potential conflict of interest relevant to this article was reported. Publisher Copyright: {\textcopyright} 2017 by the Society of Nuclear Medicine and Molecular Imaging.",

year = "2017",

month = jun,

day = "1",

doi = "10.2967/jnumed.116.182675",

language = "English",

volume = "58",

pages = "899--904",

journal = "Journal of Nuclear Medicine",

issn = "0161-5505",

publisher = "Society of Nuclear Medicine Inc.",

number = "6",

}

TY - JOUR

T1 - Prospective evaluation of changes in tumor size and tumor metabolism in patients with advanced gastric cancer undergoing chemotherapy

T2 - Association and clinical implication

AU - Park, Seongyeol

AU - Ha, Seunggyun

AU - Kwon, Hyun Woo

AU - Kim, Woo Hyoung

AU - Kim, Tae Yong

AU - Oh, Do Youn

AU - Cheon, Gi Jeong

AU - Bang, Yung Jue

N1 - Funding Information: DiSCLOSURE This study was supported by Seoul National University Hospital Research Fund (grant 25-2014-0140) to Dr. Do-Youn Oh and by a grant from the Korea Health Technology RandD Project through the Korea Health Industry Development Institute (KHIDi), funded by the Ministry of Health & Welfare, Republic of Korea (grant HI14C1072) to Gi Jeong Cheon. No other potential conflict of interest relevant to this article was reported. Publisher Copyright: © 2017 by the Society of Nuclear Medicine and Molecular Imaging.

PY - 2017/6/1

Y1 - 2017/6/1

N2 - chemotherapy remains unclear. We aimed to evaluate response of tumor size and metabolism in AGC during chemotherapy and to reveal the relationship between them in view of their impact on patient survival. Methods: We prospectively enrolled patients with AGC before the initiation of first-line palliative chemotherapy. Using baseline and follow-up contrast-enhanced CT and 18F-FDG PET, we assessed the tumor diameter, SUVmax, and total lesion glycolysis in each lesion and their changes during chemotherapy at the same time. We included all lesions with the maximal longest diameters over 1 cm on CT, and each lesion was evaluated by matched 18F-FDG PET. We analyzed the association between changes in tumor metabolism and tumor size and performed outcome analysis on overall survival (OS) and progression-free survival (PFS). Results: Seventy-four patients were enrolled, and the number of all lesions included in this study was 620. Compared with adenocarcinomas, poorly cohesive carcinomas demonstrated lower SUVmax irrespective of tumor size (P , 0.001). Human epidermal growth factor receptor 2 (HER2)-positive tumors showed higher SUVmax than HER2-negative tumors (P 5 0.002). The changes in SUVmax due to chemotherapy had a linear correlation with the changes in tumor size of each lesion, and a 30% tumor size reduction was associated with a 50% SUVmax reduction (P , 0.001). Total lesion glycolysis changes also correlated with tumor size changes (P , 0.001). Better OS and PFS were obtained in patients with both tumor size and SUVmax reduction than in patients with either size or SUVmax reduction only (OS, P 5 0.003; PFS, P 5 0.038). Conclusion: Changes in tumor metabolism induced by chemotherapy correlated with changes in tumor size in AGC. Considering both changes in metabolism and size could help predict a more accurate prognosis for AGC patients undergoing chemotherapy.

AB - chemotherapy remains unclear. We aimed to evaluate response of tumor size and metabolism in AGC during chemotherapy and to reveal the relationship between them in view of their impact on patient survival. Methods: We prospectively enrolled patients with AGC before the initiation of first-line palliative chemotherapy. Using baseline and follow-up contrast-enhanced CT and 18F-FDG PET, we assessed the tumor diameter, SUVmax, and total lesion glycolysis in each lesion and their changes during chemotherapy at the same time. We included all lesions with the maximal longest diameters over 1 cm on CT, and each lesion was evaluated by matched 18F-FDG PET. We analyzed the association between changes in tumor metabolism and tumor size and performed outcome analysis on overall survival (OS) and progression-free survival (PFS). Results: Seventy-four patients were enrolled, and the number of all lesions included in this study was 620. Compared with adenocarcinomas, poorly cohesive carcinomas demonstrated lower SUVmax irrespective of tumor size (P , 0.001). Human epidermal growth factor receptor 2 (HER2)-positive tumors showed higher SUVmax than HER2-negative tumors (P 5 0.002). The changes in SUVmax due to chemotherapy had a linear correlation with the changes in tumor size of each lesion, and a 30% tumor size reduction was associated with a 50% SUVmax reduction (P , 0.001). Total lesion glycolysis changes also correlated with tumor size changes (P , 0.001). Better OS and PFS were obtained in patients with both tumor size and SUVmax reduction than in patients with either size or SUVmax reduction only (OS, P 5 0.003; PFS, P 5 0.038). Conclusion: Changes in tumor metabolism induced by chemotherapy correlated with changes in tumor size in AGC. Considering both changes in metabolism and size could help predict a more accurate prognosis for AGC patients undergoing chemotherapy.

KW - Chemotherapy

KW - Metabolism

KW - Positron-emission tomography

KW - Prognosis

KW - Stomach neoplasm

UR - http://www.scopus.com/inward/record.url?scp=85020218680&partnerID=8YFLogxK

U2 - 10.2967/jnumed.116.182675

DO - 10.2967/jnumed.116.182675

M3 - Article

C2 - 28572288

AN - SCOPUS:85020218680

SN - 0161-5505

VL - 58

SP - 899

EP - 904

JO - Journal of Nuclear Medicine

JF - Journal of Nuclear Medicine

IS - 6

ER -

Prospective evaluation of changes in tumor size and tumor metabolism in patients with advanced gastric cancer undergoing chemotherapy: Association and clinical implication

Abstract

Bibliographical note

Keywords

UN SDGs

Access to Document

Other files and links

Fingerprint

Cite this