Abstract
1568
Objectives To evaluate the prognostic value of pretreatment 18F-FDG PET in patients with advanced renal cell carcinoma (RCC) after anti-VEGF targeted therapy.
Methods From Jan 2007 to Dec 2013, we retrospectively enrolled 56 patients with advanced RCC (44 male, 12 female, median age 60; range 37-88 years old) who underwent 18F-FDG PET/CT for staging and recur evaluation. The highest SUV in the all metastatic RCC lesions of each patient was defined as SUVmax. The tumor-to-normal liver standardized uptake value (SUV) ratio (TLR), metabolic tumor volume (MTV) and total lesion glycolysis (TLG) were measured on 18F-FDG PET/CT in all patients. MTV was defined as the sum of above 40% of tumor SUV maximum. TLG was calculated by (MTV) · (mean SUV). The prognostic significances of PET/CT parameters and clinical factors for progression-free survival (PFS) and overall survival (OS) were evaluated by univariate and multivariate analyses.
Results The most common organ for metastases was lung (35 patients). The remaining metastases were bone (26), lymph node (14), adrenal gland (8), peritoneal seeding (8), brain (2), pancreas (1), and thyroid (1). In univariate analysis, hypercalcemia, time from diagnosis to treatment, TLR, MTV and TLG were significant prognostic factors affecting PFS (p<0.05), and Karnofsky score, hypercalcemia, time from diagnosis to treatment, TLR, MTV and TLG were significant prognostic factors affecting OS (p<0.05). In multivariate analysis, hypercalcemia, MTV and TLG were independent prognostic factors for PFS (p<0.05) and hypercalcemia, time from diagnosis to treatment, MTV and TLG for OS (p<0.05).
Conclusions MTV and TLG are independent prognostic factors for predicting PFS and OS in patients with advanced RCC. 18F-FDG uptake in the tumor could provide prognostic information for advanced RCC patents who underwent anti-VEGF targeted therapy.