Clinical significance of the maximum standardized uptake value on positron emission tomography to predict treatment response and outcomes in patients with rectal cancer undergoing neoadjuvant chemoradiotherapy.

IF 1.7 4区医学 Q2 SURGERY

Surgery Today Pub Date : 2025-02-01 Epub Date: 2024-06-15 DOI:10.1007/s00595-024-02880-4

Takao Tsuneki, Takeru Matsuda, Ryuichiro Sawada, Hiroshi Hasegawa, Kimihiro Yamashita, Yasufumi Koterazawa, Hitoshi Harada, Naoki Urakawa, Hironobu Goto, Shingo Kanaji, Yoshihiro Kakeji

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Abstract

Purposes: The association between the reduction rate of the maximum standardized uptake value (SUVmax) on positron emission tomography (PET) during neoadjuvant chemoradiotherapy (NACRT) and the prognosis in patients with locally advanced rectal cancer is unknown.

Methods: We retrospectively analyzed 62 patients with locally advanced rectal cancer who underwent curative surgery after NACRT at Kobe University between 2008 and 2021. The SUVmax reduction rate was calculated from preoperative and postoperative PET scans, and its association with the prognosis was investigated.

Results: The cutoff value for SUVmax reduction rate was 61.5%. Twenty patients had an SUVmax reduction rate > 61.5% (SUV responder group) and 38 patients had an SUVmax reduction rate ≤ 61.5% (SUV nonresponder group). Regarding pathological outcomes, the rate of a good histological response was significantly higher in the SUV responder group than in the SUV nonresponder group (80.0% vs. 21.1%, p < 0.001). Both the overall (OS) and relapse-free survival (RFS) rates were significantly better in the SUV responder group than in the SUV nonresponder group (OS, p = 0.035; RFS, p = 0.019). In the SUV responder group, only 1 case of recurrence was observed, with a median follow-up period of 56 months.

Conclusion: The rate of SUVmax reduction during NACRT might predict the long-term prognosis of patients with locally advanced rectal cancer.

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正电子发射断层扫描的最大标准化摄取值对预测接受新辅助化放疗的直肠癌患者的治疗反应和预后的临床意义。

研究目的新辅助化放疗（NACRT）期间正电子发射断层扫描（PET）最大标准化摄取值（SUVmax）的降低率与局部晚期直肠癌患者预后之间的关系尚不清楚：我们回顾性分析了 2008 年至 2021 年期间在神户大学接受新辅助化放疗后进行根治性手术的 62 例局部晚期直肠癌患者。根据术前和术后 PET 扫描结果计算 SUVmax 降低率，并研究其与预后的关系：SUVmax降低率的临界值为61.5%。20例患者的SUVmax降低率大于61.5%（SUV有反应组），38例患者的SUVmax降低率小于61.5%（SUV无反应组）。在病理结果方面，SUV 反应组的组织学良好反应率明显高于 SUV 无反应组（80.0% vs. 21.1%，PNACRT期间SUVmax降低率可预测局部晚期直肠癌患者的长期预后。

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来源期刊

Surgery Today 医学-外科

CiteScore

4.90

自引率

4.00%

发文量

208

审稿时长

1 months

期刊介绍： Surgery Today is the official journal of the Japan Surgical Society. The main purpose of the journal is to provide a place for the publication of high-quality papers documenting recent advances and new developments in all fields of surgery, both clinical and experimental. The journal welcomes original papers, review articles, and short communications, as well as short technical reports("How to do it"). The "How to do it" section will includes short articles on methods or techniques recommended for practical surgery. Papers submitted to the journal are reviewed by an international editorial board. Field of interest: All fields of surgery.