Objective: To evaluate the prognostic significance of (18)F-FDG PET-CT SUVmax value in 85 patients with hepatocellular carcinoma (HCC) before transarterial chemoembolization (TACE).
Methods: A retrospective analysis was conducted on 85 patients with HCC before TACE to evaluate the prognostic significance of SUVmax of (18)F-FDG PET-CT. The survival rates were calculated using Kaplan-Meier method. Log-rank method was used for univariate analysis, and Cox regression model was used for multivariate analysis.
Results: The patients were divided into two groups before TACE: The high metabolic group (63 patients, with SUVmax value 7.71 ± 2.78) and low metabolic group (22 patients, with SUVmax value 3.89 ± 0.80). The SUVmax levels were statistically different (P < 0.001). The 1-, 2- and 3-year survival rates of the 63 patients of high metabolic group were 66.6%, 26.9% and 12.6%, respectively. The 1-, 2- and 3-year survival rates of the 22 patients of low metabolic group were 81.8%, 72.7% and 63.6%, respectively. The median survival time of the high metabolic group was 16.0 months and that of the low metabolic group was 48.0 months (P = 0.001). Univariate analysis indicated that SUVmax value of the intrahepatic primary tumor, hepatic cirrhosis, Child-Pugh score, ECOG score, intrahepatic tumor size, number of tumors(solitary or multiple), portal vein tumor thrombus, BCLC stage, and serum AFP level were significantly correlated with prognosis of the patients (P < 0.05 for all). Multivariate analysis indicated that SUVmax value, tumor size >8 cm, number of tumors (solitary or multiple) and AFP level were independent prognostic factors (P < 0.05 for all).
Conclusion: The SUVmax value of the primary intrahepatic tumor can be used as an important prognostic factor to predict the effect of TACE in patients with hepatocellular carcinoma.