Detailed Abstract
[E-poster - Liver (Liver Disease/Surgery)]
[EP 034] The use of 18F-FDG positron emission tomography to predict tumour recurrence in hepatocellular carcinoma patients after hepatectomy
Jun ZHENG*1 , Tiffany CL WONG2 , Jeff WC DAI2 , Albert CY CHAN2 , Tan-To CHEUNG2 , Chung-Mau LO2
1 Surgery, Queen Mary Hospital, HONG KONG
2 Surgery, University Of Hong Kong, HONG KONG
Background : A reliable biomarker to predict hepatocellular carcinoma (HCC) recurrence after hepatectomy is lacking. We hypothesized that pre-operative 18F-fluorodeoxyglucose (18F-FDG) uptake on positron emission tomography (PET) predicted HCC recurrence after hepatectomy.
Methods : This was a retrospective study of prospective collected data between 2004-2019. The cut-off for 18F-FDG uptake on PET for HCC recurrence was determined by Youdens’ index. Patients were stratified into PET+ve and PET-ve group. Baseline, pathological characteristics, disease-free and overall survival rates were compared.
Results : 267 patients underwent hepatectomy with preoperative PET scan. The cut-off for 18F-FDG PET positivity was 1.526 (AUC=0.674, 95% CI 0.608-0.741, P<0.001). 155 patients were PET-ve and 112 patients were PET+ve. The PET+ve group had larger tumors (8.25 vs. 3.5cm, P< 0.001), more microvascular invasion (67 vs. 36.1%, P<0.001), more poorly differentiated tumours (24.8 vs. 16.7%, P=0.03) and higher AFP≥100ng/ml (49.1 vs. 23.2% P<0.001). The time to recurrence was shorter in PET+ve patients (8.4 vs. 32.7 months, P<0.001) and there was more extrahepatic recurrence (8.9 vs. 2.6%, P<0.001). The PET-ve group had better overall and disease-free survival rates at 1-, 3- and 5-year respectively (96.1%, 84.9%, 79.8% vs. 78.2%, 54.9%, 43.1%, P<0.001; 74.6%, 55.2%, 45.8% vs. 43%, 37.1%, 33.1%, P<0.001)
Conclusions : PET+ve was associated with higher AFP and unfavourable tumour biology, with a higher risk of recurrence and inferior survival. 18F-FDG PET should be explored prospectively as a biomarker in HCC patients.
Methods : This was a retrospective study of prospective collected data between 2004-2019. The cut-off for 18F-FDG uptake on PET for HCC recurrence was determined by Youdens’ index. Patients were stratified into PET+ve and PET-ve group. Baseline, pathological characteristics, disease-free and overall survival rates were compared.
Results : 267 patients underwent hepatectomy with preoperative PET scan. The cut-off for 18F-FDG PET positivity was 1.526 (AUC=0.674, 95% CI 0.608-0.741, P<0.001). 155 patients were PET-ve and 112 patients were PET+ve. The PET+ve group had larger tumors (8.25 vs. 3.5cm, P< 0.001), more microvascular invasion (67 vs. 36.1%, P<0.001), more poorly differentiated tumours (24.8 vs. 16.7%, P=0.03) and higher AFP≥100ng/ml (49.1 vs. 23.2% P<0.001). The time to recurrence was shorter in PET+ve patients (8.4 vs. 32.7 months, P<0.001) and there was more extrahepatic recurrence (8.9 vs. 2.6%, P<0.001). The PET-ve group had better overall and disease-free survival rates at 1-, 3- and 5-year respectively (96.1%, 84.9%, 79.8% vs. 78.2%, 54.9%, 43.1%, P<0.001; 74.6%, 55.2%, 45.8% vs. 43%, 37.1%, 33.1%, P<0.001)
Conclusions : PET+ve was associated with higher AFP and unfavourable tumour biology, with a higher risk of recurrence and inferior survival. 18F-FDG PET should be explored prospectively as a biomarker in HCC patients.
SESSION
E-poster
E-Session 03/03 ~ 03/05 ALL DAY