Korean J Hematol.  2012 Sep;47(3):207-212. 10.5045/kjh.2012.47.3.207.

Clinical significance of standardized uptake value and maximum tumor diameter in patients with primary extranodal diffuse large B cell lymphoma

• Oh MY
• Oh SB
• Seoung HG
• Kim JH
• Kim SM
• Kim TK
• Song MK
• Shin HJ
• Chung JS

• KMID: 2251955
• DOI: http://doi.org/10.5045/kjh.2012.47.3.207

Abstract

BACKGROUND
Maximum standardized uptake value (SUVmax) and maximum tumor diameter (MTD) have been shown to reflect survival outcome in diffuse large B cell lymphoma (DLBCL). However, applying these values to primary extranodal DLBCL is difficult because they are separate nosological entities with differences in genetic origin. We therefore decided to evaluate whether SUVmax and MTD on 2-[fluorine-18]-fluoro-2-deoxy-D-glucose (18-FDG) positron emission tomography (PET) would affect the survival outcome in primary extranodal DLBCL.
METHODS
From October 2005 to November 2010, 76 primary extranodal DLBCL patients receiving R-CHOP therapy were analyzed. All patients had undergone an initial 18-FDG PET/CT and conventional computed tomography (CT) of the neck, chest, abdomen, and pelvis for staging. Median follow-up period was 35 months.
RESULTS
The SUVmax and MTD cut-off values were 11.0 and 7.5 cm, respectively. SUVmax> or =11.0 predicted a short progression free survival (PFS, P=0.002) and overall survival (OS, P=0.002). MTD> or =7.5 cm was associated with poor PFS (P=0.003) and OS (P=0.003). High International Prognostic Index (IPI) was also associated with the survival outcome (PFS, P=0.046; OS, P=0.030). Multivariate analysis revealed that SUVmax> or =11.0 (PFS, hazard ratio [HR]=10.813, P=0.024; OS, HR=6.312, P=0.015); MTD> or =7.5 cm (PFS, HR=5.631, P=0.008; OS, HR=4.072, P=0.008); and high IPI (PFS, P=0.027; OS, P=0.046) were independent prognostic factors.
CONCLUSION
It appears that both MTD and SUVmax can be independent prognostic factors in primary extranodal DLBCL.

Keyword

Lymphoma; Large B-cell; Extranodal

MeSH Terms

Abdomen
Disease-Free Survival
Follow-Up Studies
Humans
Lymphoma
Lymphoma, B-Cell
Multivariate Analysis
Neck
Pelvis
Positron-Emission Tomography
Thorax

Figure

• 

  Fig. 1 Progression-free survival and overall survival according to SUVmax and MTD. (A, B) The cut-off value of SUVmax was 11.0. SUVmax more than 11.0 was significantly associated with poor survival outcome (PFS, P=0.002; OS, P=0.002). (C, D) The cut-off value of MTD was 7.5 cm. MTD above than 7.5 cm was also significantly associated with poor survival outcome (PFS, P=0.003; OS, P=0.003).

• 

  Fig. 2 Progression-free survival and overall survival according to IPI score. High IPI score was defined as 3 or more. High IPI score was significantly associated with poor progression-free survival (A) and overall survival (B) outcome.

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