18F FDG PET/CT after Neoadjuvant Chemotherapy and Pathological Responses are Predictive Factors for Disease-Free Survival and Overall Survival in Patients with Locally Advanced Breast Cancer: A Prospective Study

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Kupik O., TUNCEL M., AKSOY S., Kiratli P. O., GÜLSÜN AKPINAR M., Altundag K., ...Daha Fazla

UHOD-ULUSLARARASI HEMATOLOJI-ONKOLOJI DERGISI, cilt.32, sa.3, ss.150-158, 2022 (SCI-Expanded) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 32 Sayı: 3
  • Basım Tarihi: 2022
  • Doi Numarası: 10.4999/uhod.226370
  • Dergi Adı: UHOD-ULUSLARARASI HEMATOLOJI-ONKOLOJI DERGISI
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, EMBASE
  • Sayfa Sayıları: ss.150-158
  • Anahtar Kelimeler: Breast cancer, Neoadjuvant chemotherapy, Fluorodeoxyglucose, PE T, CT, Survival, EMISSION TOMOGRAPHY/COMPUTED TOMOGRAPHY, SURGICAL ADJUVANT BREAST, COMPLETE REMISSION, SYSTEMIC THERAPY, PROGNOSTIC VALUE, F-18-FDG PET/CT, TUMOR RESPONSE, DOXORUBICIN, RECURRENCE, PACLITAXEL
  • Hacettepe Üniversitesi Adresli: Evet

Özet

We investigated the prognostic value of interim and post-neoadjuvant chemotherapy (NAC) 18F FDG PET/CT and the complete pathological and metabolical response after NAC for disease-free survival (DFS) and overall survival (OS) in patients with locally advanced breast cancer (LABC) receiving NAC. Patients who were decided to receive NAC were evaluated with baseline (PET1), after 2-3 cycles of chemotherapy (interim-PET2), and after NAC-before surgery (PET3) with 18F FDG PET/CT. The primary tumor SUV and the total metabolic tumor volume (MTV) of the primary tumor+axillary lymph nodes were calculated and defined for PET1-2-3 as SUV1-2-3 and MTV1-2-3. We also calculated ??%SUV and ??%MTV for PET1-2 and PET1-3. The relation between parameters and survival was evaluated with Cox regression analysis. Patients were grouped as a complete metabolic response or not (metCR/nonmetCR) according to PET3 and as PCR/non-PCR according to the presence of residual invasive tumor as a result of pathology after NAC. Forty-two patients were analyzed (46.36??10.4 years old). The median follow-up time was 94.3 months. For DFS and OS, only MTV from post-NAC PET/CT was an independent predictor. For MTV3 ??? 2.1 mL vs. > 2.1 mL, 7-year DFS and OS were 81.3% - 50%, (p= 0.038) and 88.2% and 55.6%, (p= 0.042) respectively. Survival was statistically significantly different in the PCR/non-PCR patient groups. There was no difference in DFS between patients with metCR/non-metCR, only between groups for OS (Log-rank). MTV (??? 2.1mL vs. > 2.1mL) obtained from 18F FDG PET/CT after NAC-pre-surgery and complete pathological response might distinguish patients with poor prognosis.