| International Session (Symposium) 7 (JSGS・JSGE・JSH) |
| Sat. November 3rd 14:00 - 17:00 Room 4: Portopia Hotel South Wing Portopia Hall |
| The judging resection limit based on FDG-PET for managing liver metastasis from colorectal cancer | |||
| Akira Watanabe1, Norihumi Harimoto1,2, Ken Shirabe1 | |||
| 1Department of Hepatobiliary and Pancreatic Surgery, Gunma University Graduate School of Medicine, 2Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University | |||
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| Background: The surgical indication of liver metastasis from colorectal cancer (CRLM) had extended currently, but early recurrence is a problem on advance cases. Effective prognostic models are needed to manage CRLM. Thus, we developed an algorithm to guide treatment based on the standardized uptake value (SUV) from fluorodeoxyglucose-positron emission tomography (FDG-PET). Study Design: We retrospectively evaluated 148 patients who underwent surgery for CRLM, including 107 cases that involved primary surgery and 41 cases that involved preoperative chemotherapy before conversion surgery. We evaluated the relationship between the perioperative SUV and postoperative prognosis in the primary surgery cases, as well as the relationship between the SUV change rate (post-chemotherapy SUV divided by pre-chemotherapy SUV) and prognosis after conversion surgery. Results: In the primary surgery group, recurrence free survival (RFS) was independently predicted by an SUV of ≥6.04 (P = 0.042) and ≥4 liver metastases (P = 0.003). In addition, the combination of an SUV of ≥6.04 and ≥4 liver metastases was strongly associated with poor RFS (p < 0.001). In the conversion surgery group, the SUV change rate was associated with tumor size change, CA19-9 change, and pathological response. An SUV change rate of ≥0.293 was associated with shorter RFS (P = 0.006) and also independently predicted RFS (P = 0.026). Conclusion: FDG-PET may be a useful modality for predicting recurrence and prognosis in cases of CRLM, and be useful for judging the resection limit |
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Index Term 1: wasson Index Term 2: wasson |
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