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Research ArticleClinical Investigations

Metabolic Tumor Volume Predicts Disease Progression and Survival in Patients with Squamous Cell Carcinoma of the Anal Canal

Jose G. Bazan, Albert C. Koong, Daniel S. Kapp, Andrew Quon, Edward E. Graves, Billy W. Loo and Daniel T. Chang
Journal of Nuclear Medicine January 2013, 54 (1) 27-32; DOI: https://doi.org/10.2967/jnumed.112.109470
Jose G. Bazan
1Department of Radiation Oncology, Stanford University, Stanford, California; and
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Albert C. Koong
1Department of Radiation Oncology, Stanford University, Stanford, California; and
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Daniel S. Kapp
1Department of Radiation Oncology, Stanford University, Stanford, California; and
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Andrew Quon
2Department of Radiology, Division of Nuclear Medicine, Stanford University, Stanford, California
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Edward E. Graves
1Department of Radiation Oncology, Stanford University, Stanford, California; and
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Billy W. Loo Jr.
1Department of Radiation Oncology, Stanford University, Stanford, California; and
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Daniel T. Chang
1Department of Radiation Oncology, Stanford University, Stanford, California; and
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  • FIGURE 1.
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    FIGURE 1.

    Representative PET maximum-intensity-projection images with MTV represented by dashed line on coronal (A) and sagittal (B) images. Sagittal image demonstrates clearer separation between tumor and bladder.

  • FIGURE 2.
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    FIGURE 2.

    MTV-T by T classification of American Joint Committee on Cancer (AJCC).

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    FIGURE 3.

    Kaplan–Meier analysis of PFS (A), EFS (B), and OS (C) by MTV-T. Patients were separated into 2 groups based on receiver-operating-characteristic analysis. Solid line = patients with MTV ≤ 26 mL; dotted line = patients with MTV > 26 mL; ○ = censored individuals.

Tables

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    TABLE 1

    Patient Characteristics

    Characteristicn
    Sex
     Female24
     Male15
    HIV-positive4 (10)
    T class
     T16 (15)
     T220 (51)
     T310 (26)
     T43 (8)
    N class
     N027 (70)
     N16 (15)
     N24 (10)
     N32 (5)
    Chemotherapy
     MMC/5FU34
     Cisplatin-based4
     5FU alone1
    • Median patient age was 58 y, and age range was 40–87 y. Data in parentheses are percentages.

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    TABLE 2

    Cox Univariate Analysis

    OSPFSEFS
    ParameterHRPHRPHRP
    Age (per y)1.060.171.020.481.030.28
    Sex (female vs. male)0.4670.412.490.261.450.55
    T stage (T3/T4 vs. T1/T2)5.480.075.010.024.110.02
    Nodal status (N-positive vs. N-negative)1.740.551.510.561.480.52
    HIV status (HIV-positive vs. HIV-negative)1.920.560.8810.910.6620.69
    MMC-based chemotherapy (yes vs. no)0.0920.020.670.710.380.22
    Time between PET and treatment (d)0.950.491.0480.231.0220.58
    MTV-T (per cm3)1.020.041.030.0041.030.002
    MTV-P1.020.0481.040.0011.030.004
    MTV-N1.160.0291.200.0151.190.019
    TGA (per cm3)1.0030.0531.0040.0061.0030.02
    SUVmax (per unit)1.000.990.9900.851.0030.95
    SUVmax-P1.000.980.990.841.000.96
    SUVmax-N1.080.331.080.231.060.23
    SUVpeak (per unit)0.9540.601.040.351.030.47
    SUVpeak-P0.960.681.010.941.010.93
    SUVpeak-N1.080.401.100.181.070.27
    SUVmean (per unit)0.9600.730.9000.280.9330.39
    • View popup
    TABLE 3

    Cox Multivariate Analysis

    OSPFSEFS
    ParameterHRPHRPHRP
    MTV-T (per mL)1.0140.191.0280.011.0240.022
    T class (T3/T4 vs. T1/T2)4.130.163.730.073.330.052
    MTV-T (per mL)1.0260.021.0370.0021.0330.003
    Age (per y)1.0790.101.0390.231.0420.13
    MTV-T (per mL)1.0190.061.0370.0011.0290.004
    Gender (female vs. male)0.5610.553.4370.191.4380.57
    MTV-T (per mL)1.0200.071.0330.0031.0280.006
    Nodal status (N-positive vs. N-negative)1.0860.930.9951.01.1830.80
    MTV-T (per mL)1.0240.131.0450.0051.0350.005
    HIV status (HIV-positive vs. HIV-negative)0.5880.750.1280.310.2540.35
    MTV-T (per mL)1.0280.021.0340.0021.0310.003
    MMC-based chemotherapy (yes vs. no)0.0540.010.4740.500.2930.13
    MTV-T (per mL)1.020.041.0330.0021.0290.004
    SUVmax0.9870.870.9700.650.9920.88
    MTV-T (per mL)1.0230.031.0320.0021.0280.005
    SUVpeak0.9110.421.0260.611.0120.79
    MTV-T (per mL)1.0200.041.0330.0011.0280.004
    SUVmean0.9530.720.8740.260.9260.39
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Journal of Nuclear Medicine: 54 (1)
Journal of Nuclear Medicine
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January 1, 2013
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Metabolic Tumor Volume Predicts Disease Progression and Survival in Patients with Squamous Cell Carcinoma of the Anal Canal
Jose G. Bazan, Albert C. Koong, Daniel S. Kapp, Andrew Quon, Edward E. Graves, Billy W. Loo, Daniel T. Chang
Journal of Nuclear Medicine Jan 2013, 54 (1) 27-32; DOI: 10.2967/jnumed.112.109470

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Metabolic Tumor Volume Predicts Disease Progression and Survival in Patients with Squamous Cell Carcinoma of the Anal Canal
Jose G. Bazan, Albert C. Koong, Daniel S. Kapp, Andrew Quon, Edward E. Graves, Billy W. Loo, Daniel T. Chang
Journal of Nuclear Medicine Jan 2013, 54 (1) 27-32; DOI: 10.2967/jnumed.112.109470
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Keywords

  • PET
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