Article Figures & Data
Figures
- FIGURE 1.
(A) Distribution of initial SUVmax. (B) SUVmax reduction at best metabolic response and at first 18F-FDG PET evaluation. (C) Distribution of initial SUVmax according to primary tumor origin.
- FIGURE 2.
PFS according to initial SUVmax (A) and SUVmax reduction at best metabolic response (B). OS according to initial SUVmax (C) and SUVmax reduction at best metabolic response (D).
- FIGURE 3.
PFS (A) and OS (B) after patients were divided into 4 groups by initial SUVmax and its response.
Tables
Characteristic Value (n = 75) Women (n) 32 (42.7%) Median age (y) 64.0 (range, 46.0–83.0) Median BMI (kg/m2) 23.4 (range, 15.8–30.0) ECOG performance-status score (n) 0/1 to 2 20 (26.7%)/55 (73.3%) Primary tumor site (n) Gallbladder cancer 28 (37.3%) IHCC 22 (29.3%) EHCC 19 (25.3%) AoV cancer 6 (8.0%) Pathologic differentiation (n) WD/MD/PD 3 (4.0%)/38 (50.7%)/12 (16.0%) HER 2 immunohistochemistry (n) Negative to 1+ 33 (44.0%) 2+ to 3+ 10 (13.3%) HER 2 FISH (n) Negative/positive 5 (6.7%)/3 (4.0%) c-MET cytoplasm immunohistochemistry (n) Negative to 1+ 36 (48.0%) 2+ to 3+ 7 (9.3%) c-MET membrane immunohistochemistry (n) Negative to 1+ 16 (21.3%) 2+ to 3+ 27 (36.0%) c-Myc Negative/positive 28 (37.3%)/12 (16.0%) Median CEA (ng/mL) 2.6 (range, 0.5–182.9) Median CA 19-9 (U/mL) 133 (range, 2.0–36,000.0) Median WBC (μL) 6,300 (range, 2,890–16,330) Median total bilirubin (mg/dL) 0.6 (range, 0.3–3.3) Median albumin (mg/dL) 3.9 (range, 3.3–4.7) Curative/palliative operation (n) 40 (78.4%)/11 (21.6%) Unresectable/recurrent disease (n) 35 (46.7%)/40 (53.3%) Best response (n) PR/SD/PD 12 (16.7%)/45 (62.5%)/15 (20.8%) Median follow-up duration (mo) 6.8 (1.0–27.2) Median PFS (mo) 5.6 (95% CI, 4.4–6.8) Median OS (mo) 13.2 (95% CI, 7.1–19.3) BMI = body mass index; ECOG = Eastern Cooperative Oncology Group; WD = well differentiated; MD = moderately differentiated; PD = poorly differentiated; HER 2 = human epidermal growth factor receptor 2; FISH = fluorescent in situ hybridization; CEA = carcinoembryonic antigen; CA 19-9 = carbohydrate antigen 19-9; WBC = white blood cell; CR = complete response; PR = partial response; SD = stable disease; PD = progressive disease.
Characteristic Low-metabolism group, SUVmax ≤ 9.0 (n = 46) High-metabolism group, SUVmax > 9.0 (n = 29) P Primary tumor site (n) 0.013 Gallbladder cancer 12 (26.1%) 16 (55.2%) IHCC 14 (30.4%) 8 (27.6%) EHCC 17 (37.0%) 2 (6.9%) AoV cancer 3 (6.5%) 3 (10.3%) Histologic differentiation (n) 0.034 WD 1 (2.6%) 2 (13.3%) MD 31 (81.6%) 7 (46.7%) PD 6 (15.8%) 6 (40.0%) c-Myc, positive 3 (12,5%) 9 (56.2%) 0.005 Initial presentation at enrollment (n) <0.001 Metastatic disease 14 (30.4%) 21 (72.4%) Recurrent disease 32 (69.6%) 8 (27.6%) Mean WBC (μL) 5,980.4 ± 1,857.4 7,473.1 ± 3,032.8 0.010 Mean no. of organs with 18F-FDG uptake 1.5 ± 1.1 2.3 ± 1.0 0.004 Mean no. of lesions with 18F-FDG uptake 2.9 ± 3.5 7.0 ± 7.9 0.012 WD = well differentiated; MD = moderately differentiated; PD = poorly differentiate; WBC = white blood cell.
Univariate analysis Multivariate analysis Variable Median PFS (mo) 95% CI P HR 95% CI P Primary tumor origin 0.013 0.003 Gallbladder cancer 5.3 2.8–7.8 0.476 0.17–1.32 IHCC 8.3 5.0–11.6 Ref EHCC 5.0 2.2–7.8 2.31 0.83–6.50 AoV cancer 1.3 0.7–1.9 3.26 0.83–12.85 c-Myc 0.044 Negative 7.0 2.5–11.5 Positive 3.8 0.4–7.2 Initial SUVmax 0.002 4.09 1.73–9.66 0.001 ≤9.0 7.0 4.8–9.2 >9.0 3.8 2.2–5.4 SUVmax reduction (at best 18F-FDG PET response) <0.001 3.35 1.55–7.20 0.002 ≥20.0% 8.8 5.8–11.8 <20.0% 3.9 3.3–4.5 Organs with 18F-FDG uptake (n) 0.134 0–2 6.3 4.8–7.9 ≥3 3.9 2.2–5.6 Univariate analysis Multivariate analysis Variable Median OS (mo) 95% CI P HR 95% CI P Age (y) 0.094 ≤65 19.1 9.8–28.4 >65 8.9 6.0–11.8 CEA (ng/mL) 0.062 ≤5.0 18.4 15.8–21.0 >5.0 8.9 4.7–13.1 Initial SUVmax 0.003 2.61 1.18–5.81 0.019 ≤10.0 19.1 16.1–22.1 10.0 10.9 3.8–18.1 SUVmax reduction (at best 18F-FDG PET response) 0.074 1.96 0.91–4.20 0.082 ≥20.0% 20.7 5.8–35.6 20.0% 13.2 2.8–23.6 Organs with 18F-FDG uptake (n) 0.039 2.08 0.95–4.57 0.068 0–2 18.4 10.3–26.5 ≥3 8.9 2.3–15.5 CEA = carcinoembryonic antigen.
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