Ann Surg Treat Res.  2018 Apr;94(4):183-189. 10.4174/astr.2018.94.4.183.

Prognosis of preoperative positron emission tomography uptake in hepatectomy patients

Affiliations
  • 1Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. jw.joh@samsung.com
  • 2Division of Gastroenterology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Abstract

PURPOSE
Preoperative F-18-fluoro-2-deoxy-glucose positron emission tomography (18F-FDG PET) imaging results appear to predict tumor recurrence and patient survival. The present study compared outcomes between PET-positive and PET-negative groups with HBV-related hepatocellular carcinoma (HCC) who underwent curative hepatectomy and assessed the prognostic value of positive PET-CT for HCC recurrence and death.
METHODS
This study included patients who underwent liver resection of solitary HCC between 2007 and 2014 based on preoperative radiological images. There were 133 patients in the PET-positive group and 93 in the PET-negative group.
RESULTS
There were no statistically significant differences in baseline, perioperative, or pathologic characteristics between the 2 groups except HBsAg titer, tumor size, and presence of bile duct tumor thrombi. Multivariate analysis showed that tumor size >3.5 cm and HBsAg titer >1,000 cutoff index were predisposing factors of positive PET-CT. Disease-free survival and overall survival rate at 1, 3, and 5 years were 76.3%, 64.4%, 60.3% and 96.8%, 91.1%, 85.1% in the PET-negative group, respectively, compared with 70.7%, 62.2%, 58.9% and 98.5%, 97.0%, 97.0% in the PET-positive group (P = 0.547 and P = 0.046). Multivariate analysis showed that positive PET-CT was closely associated with increased patient survival, but was not related to HCC recurrence.
CONCLUSION
These results suggest that positive PET findings are not a predisposing factor for recurrence of HBV-related HCC patients, but appear to be associated with improved patient survival. Further prospective studies are needed to confirm the prognostic value of 18F-FDG PET in these patients.

Keyword

Hepatocellular carcinoma; Hepatitis B virus; Outcome

MeSH Terms

Bile Ducts
Carcinoma, Hepatocellular
Causality
Disease-Free Survival
Electrons*
Fluorodeoxyglucose F18
Hepatectomy*
Hepatitis B Surface Antigens
Hepatitis B virus
Humans
Liver
Multivariate Analysis
Positron-Emission Tomography*
Prognosis*
Prospective Studies
Recurrence
Survival Rate
Fluorodeoxyglucose F18
Hepatitis B Surface Antigens
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