Prognostic value of positron emission tomography/computed tomography for adjuvant chemotherapy of colon cancer

ANZ J Surg. 2018 Jun;88(6):587-591. doi: 10.1111/ans.14098. Epub 2017 Jul 7.

Abstract

Background: To assess the prognostic value of preoperative 18 F-fluorodeoxyglucose positron emission tomography/computed tomography in patients with high-risk stage II or stage III colon cancer who underwent FOLFOX chemotherapy.

Methods: The study included 166 patients with high-risk stage II or stage III colon cancer who received FOLFOX4 chemotherapy. Retrospective patient data were analysed including pathological stage, histology, disease-free survival (DFS) and the maximum standardized uptake value (SUVmax ) of the primary tumour on 18 F-fluorodeoxyglucose positron emission tomography/computed tomography. The primary end point was DFS.

Results: There were recurrences in 29 of the 166 patients (17.4%). Measuring the area under the receiver operating characteristic curve, the cut-off value of SUVmax with maximum sensitivity and specificity was 10.95. Using the Kaplan-Meier method, the DFS of the patients categorized by SUVmax tended to differ (P = 0.055). In univariate analyses, the risk factors for DFS were age over 70 years, higher N stage and neural invasion. SUVmax ≤ 10.95 showed a tendency, but was not significant (P = 0.0604). In multivariate analyses, the risk factors for DFS were age over 70 and neural invasion.

Conclusions: The results of this study suggest that high fluorodeoxyglucose uptake of the primary mass in high-risk stage II and stage III colon cancer does not significantly correlate with DFS.

Keywords: FOLFOX; colon cancer; positron-emission tomography; prognosis.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols
  • Chemotherapy, Adjuvant
  • Cohort Studies
  • Colectomy / methods
  • Colonic Neoplasms / diagnostic imaging*
  • Colonic Neoplasms / drug therapy*
  • Colonic Neoplasms / mortality
  • Colonic Neoplasms / pathology
  • Disease-Free Survival
  • Female
  • Fluorodeoxyglucose F18*
  • Fluorouracil
  • Humans
  • Kaplan-Meier Estimate
  • Leucovorin
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Neoplasm Invasiveness / pathology
  • Neoplasm Staging
  • Organoplatinum Compounds
  • Positron Emission Tomography Computed Tomography / methods*
  • Prognosis
  • Proportional Hazards Models
  • ROC Curve
  • Republic of Korea
  • Retrospective Studies
  • Risk Assessment
  • Sensitivity and Specificity
  • Survival Analysis
  • Treatment Outcome

Substances

  • Organoplatinum Compounds
  • Fluorodeoxyglucose F18
  • Leucovorin
  • Fluorouracil

Supplementary concepts

  • Folfox protocol