METHODS: The preoperative 18F-FDG PET/CT from all SECA 1 and 2 patients was evaluated. MTV was obtained from all liver metastases. The patients were divided into one group with low MTV (< 70 cm3) and one group with high MTV (> 70 cm3) based on a receiver operating characteristic analysis. Overall survival (OS), disease-free survival (DFS) and post recurrence survival (PRS) for patients with low versus high MTV were compared using the Kaplan-Meier method and log rank test. Clinopathological features between the two groups were compared by a nonparametric Mann-Whitney U test for continuous and Fishers exact test for categorical data.
RESULTS: At total of 40 patients were included. Patients with low MTV had significantly longer OS (p < 0.001), DFS (p < 0.001) and PRS (p = 0.006) compared to patients with high values. The patients with high MTV had higher CEA levels, number of liver metastases, size of the largest liver metastasis, N-stage, number of chemotherapy lines and more frequently progression of disease at LT compared to the patients with low MTV.
CONCLUSIONS: MTV of liver metastases is highly predictive of long-term OS, DFS and PRS after LT for unresectable CRLM and should be implemented in risk stratification prior to LT.
方法:评估所有SECA1和2例患者的术前18F-FDGPET/CT。MTV来自所有肝转移。根据受试者工作特征分析,将患者分为一组MTV低(<70cm3)和一组MTV高(>70cm3)。总生存期(OS),使用Kaplan-Meier方法和对数秩检验比较了低和高MTV患者的无病生存期(DFS)和复发后生存期(PRS).通过非参数Mann-WhitneyU检验对连续数据和Fishers精确检验对两组之间的临床病理学特征进行了比较。
结果:共纳入40例患者。低MTV患者的OS显著延长(p<0.001),DFS(p<0.001)和PRS(p=0.006)与患者比拟值较高。MTV高的患者有较高的CEA水平,肝转移的数量,最大肝转移的大小,N级,与低MTV患者相比,LT时化疗线路数量和疾病进展频率更高。
结论:肝转移的MTV是长期OS的高度预测,对于无法切除的CRLM,LT后的DFS和PRS应在LT前进行风险分层。