Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Typ-2-Diabetes und Adipositas Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende

Die Highlights vom Kongress des American College of Cardiology 2024

Im April diskutierten die Herz-Kreislauf-Spezialisten aus der ganzen Welt auf dem  Kongress des American College of Cardiology (ACC) u.a. neue Therapieansätze bei akutem Myokardinfarkt, koronarer Herzerkrankung, kardiogenem Schock oder Aortenklappenstenose. In unserem Kongress-Dossier haben wir für Sie Berichte über die „Late-Breaking Trials“ und andere wichtige Studien zusammengestellt. 
Erweiterte Suche
Anmelden
nach oben
Annals of Nuclear Medicine
Erschienen in: Annals of Nuclear Medicine 8/2013

01.10.2013 | Original Article

Prognostic implication of extrarenal metabolic tumor burden in advanced renal cell carcinoma treated with targeted therapy after nephrectomy

verfasst von: Hai-Jeon Yoon, Jin Chul Paeng, Cheol Kwak, Yong Hyun Park, Tae Min Kim, Se-Hoon Lee, June-Key Chung, E. Edmund Kim, Dong Soo Lee

Erschienen in: Annals of Nuclear Medicine | Ausgabe 8/2013

Einloggen, um Zugang zu erhalten

Abstract

Objective

In the era of targeted therapy for advanced renal cell carcinoma (RCC), appropriate prognosis prediction is necessary for optimal therapy with or without cytoreductive surgery. We evaluated prognostic implication of extrarenal metabolic tumor burden in nephrectomized patients with advanced RCC.

Methods

Forty-four patients with advanced RCC who underwent 18F-fluorodeoxyglucose PET/CT were retrospectively enrolled. The patients were treated with nephrectomy and targeted therapy. On PET/CT image of each patient, maximal standardized uptake value (SUVmax) of lesions were measured, and metabolic tumor burden was measured as total lesion glycolysis (TLG) by multiplying tumor volume and mean SUV. An overall TLG was calculated as the sum of those of all lesions. The prognostic value of PET parameters (SUVmax and TLG), and established major clinical factors (serum hemoglobin and corrected calcium, and number of metastatic sites) were tested with regard to overall survival.

Results

Among 44 patients, 8 died during mean follow-up time of 21.9 ± 17.7 months. On FDG PET/CT, a total of 250 lesions were analyzed. In univariate analyses, SUVmax, TLG, number of metastatic sites, serum hemoglobin and corrected calcium were significant prognostic factors. Among them, TLG remained as an independent prognostic factor in a multivariate analysis (P = 0.038). In subgroup analyses, TLG was still a significant prognostic factor in patients treated with sunitinib only and in patients on the first staging as well as restaging.

Conclusions

Extrarenal metabolic tumor burden is a significant prognostic factor in advanced RCC patients treated with targeted therapy. In selection of candidates for cytoreductive surgery, the measurement of metabolic tumor burden may be effective.
Literatur
1.
Siegel R, Ward E, Brawley O, Jemal A. Cancer statistics, 2011: the impact of eliminating socioeconomic and racial disparities on premature cancer deaths. CA Cancer J Clin. 2011;61:212–36.PubMedCrossRef
2.
3.
Pirrotta MT, Bernardeschi P, Fiorentini G. Targeted-therapy in advanced renal cell carcinoma. Curr Med Chem. 2011;18:1651–7.PubMedCrossRef
4.
Crispen PL, Blute ML. Role of cytoreductive nephrectomy in the era of targeted therapy for renal cell carcinoma. Curr Urol Rep. 2012;13:38–46.PubMedCrossRef
5.
Choueiri TK, Xie W, Kollmannsberger C, North S, Knox JJ, Lampard JG, et al. The impact of cytoreductive nephrectomy on survival of patients with metastatic renal cell carcinoma receiving vascular endothelial growth factor targeted therapy. J Urol. 2011;185:60–6.PubMedCrossRef
6.
Alt AL, Boorjian SA, Lohse CM, Costello BA, Leibovich BC, Blute ML. Survival after complete surgical resection of multiple metastases from renal cell carcinoma. Cancer. 2011;117:2873–82.PubMedCrossRef
7.
Barbastefano J, Garcia JA, Elson P, Wood LS, Lane BR, Dreicer R, et al. Association of percentage of tumour burden removed with debulking nephrectomy and progression-free survival in patients with metastatic renal cell carcinoma treated with vascular endothelial growth factor-targeted therapy. BJU Int. 2010;106:1266–9.PubMedCrossRef
8.
Larson SM, Erdi Y, Akhurst T, Mazumdar M, Macapinlac HA, Finn RD, et al. Tumor treatment response based on visual and quantitative changes in global tumor glycolysis using PET-FDG imaging. The visual response score and the change in total lesion glycolysis. Clin Positron Imaging. 1999;2:159–71.PubMedCrossRef
9.
Wahl RL, Jacene H, Kasamon Y, Lodge MA. From RECIST to PERCIST: evolving considerations for PET response criteria in solid tumors. J Nucl Med. 2009;50(Suppl 1):122S–50S.PubMedCrossRef
10.
Namura K, Minamimoto R, Yao M, Makiyama K, Murakami T, Sano F, et al. Impact of maximum standardized uptake value (SUVmax) evaluated by 18-Fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography (18F-FDG-PET/CT) on survival for patients with advanced renal cell carcinoma: a preliminary report. BMC Cancer. 2010;10:667.PubMedCrossRef
11.
Orrell DH. Albumin as an aid to the interpretation of serum calcium. Clin Chim Acta. 1971;35:483–9.PubMedCrossRef
12.
Motzer RJ, Mazumdar M, Bacik J, Berg W, Amsterdam A, Ferrara J. Survival and prognostic stratification of 670 patients with advanced renal cell carcinoma. J Clin Oncol. 1999;17:2530–40.PubMed
13.
Motzer RJ, Bacik J, Schwartz LH, Reuter V, Russo P, Marion S, et al. Prognostic factors for survival in previously treated patients with metastatic renal cell carcinoma. J Clin Oncol. 2004;22:454–63.PubMedCrossRef
14.
15.
Montie JE, Stewart BH, Straffon RA, Banowsky LH, Hewitt CB, Montague DK. The role of adjunctive nephrectomy in patients with metastatic renal cell carcinoma. J Urol. 1977;117:272–5.PubMed
16.
Flanigan RC, Mickisch G, Sylvester R, Tangen C, Van Poppel H, Crawford ED. Cytoreductive nephrectomy in patients with metastatic renal cancer: a combined analysis. J Urol. 2004;171:1071–6.PubMedCrossRef
17.
Lara PN Jr, Tangen CM, Conlon SJ, Flanigan RC, Crawford ED. Predictors of survival of advanced renal cell carcinoma: long-term results from Southwest Oncology Group Trial S8949. J Urol. 2009;181:512–6.PubMedCrossRef
18.
Kim BK, Kang WJ, Kim JK, Seong J, Park JY, Kim DY, et al. (18) F-fluorodeoxyglucose uptake on positron emission tomography as a prognostic predictor in locally advanced hepatocellular carcinoma. Cancer. 2011;117:4779–87.PubMedCrossRef
19.
Costelloe CM, Macapinlac HA, Madewell JE, Fitzgerald NE, Mawlawi OR, Rohren EM, et al. 18F-FDG PET/CT as an indicator of progression-free and overall survival in osteosarcoma. J Nucl Med. 2009;50:340–7.PubMedCrossRef
20.
Chihara D, Oki Y, Onoda H, Taji H, Yamamoto K, Tamaki T, et al. High maximum standard uptake value (SUVmax) on PET scan is associated with shorter survival in patients with diffuse large B cell lymphoma. Int J Hematol. 2011;93:502–8.PubMedCrossRef
21.
Motzer RJ, Bukowski RM, Figlin RA, Hutson TE, Michaelson MD, Kim ST, et al. Prognostic nomogram for sunitinib in patients with metastatic renal cell carcinoma. Cancer. 2008;113:1552–8.PubMedCrossRef
22.
Eisenhauer EA, Therasse P, Bogaerts J, Schwartz LH, Sargent D, Ford R, et al. New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1). Eur J Cancer. 2009;45:228–47.PubMedCrossRef
23.
Tateishi U, Gamez C, Dawood S, Yeung HW, Cristofanilli M, Macapinlac HA. Bone metastases in patients with metastatic breast cancer: morphologic and metabolic monitoring of response to systemic therapy with integrated PET/CT. Radiology. 2008;247:189–96.PubMedCrossRef
24.
Benz MR, Allen-Auerbach MS, Eilber FC, Chen HJ, Dry S, Phelps ME, et al. Combined assessment of metabolic and volumetric changes for assessment of tumor response in patients with soft-tissue sarcomas. J Nucl Med. 2008;49:1579–84.PubMedCrossRef
25.
Schwarz-Dose J, Untch M, Tiling R, Sassen S, Mahner S, Kahlert S, et al. Monitoring primary systemic therapy of large and locally advanced breast cancer by using sequential positron emission tomography imaging with [18F]fluorodeoxyglucose. J Clin Oncol. 2009;27:535–41.PubMedCrossRef
26.
[26] Gilles R, de Geus-Oei LF, Mulders PF, Oyen WJ. Immunotherapy response evaluation with (18)F-FDG-PET in patients with advanced stage renal cell carcinoma. World J Urol 2011.
27.
Arslan N, Tuncel M, Kuzhan O, Alagoz E, Budakoglu B, Ozet A, et al. Evaluation of outcome prediction and disease extension by quantitative 2-deoxy-2-[18F] fluoro-D-glucose with positron emission tomography in patients with small cell lung cancer. Ann Nucl Med. 2011;25:406–13.PubMedCrossRef
28.
Lee HY, Hyun SH, Lee KS, Kim BT, Kim J, Shim YM, et al. Volume-based parameter of [18]F-FDG PET/CT in malignant pleural mesothelioma: prediction of therapeutic response and prognostic implications. Ann Surg Oncol. 2010;17:2787–94.PubMedCrossRef
29.
Powles T, Chowdhury S, Jones R, Mantle M, Nathan P, Bex A, et al. Sunitinib and other targeted therapies for renal cell carcinoma. Br J Cancer. 2011;104:741–5.PubMedCrossRef
Metadaten
Titel
Prognostic implication of extrarenal metabolic tumor burden in advanced renal cell carcinoma treated with targeted therapy after nephrectomy
verfasst von
Hai-Jeon Yoon
Jin Chul Paeng
Cheol Kwak
Yong Hyun Park
Tae Min Kim
Se-Hoon Lee
June-Key Chung
E. Edmund Kim
Dong Soo Lee
Publikationsdatum
01.10.2013
Verlag
Springer Japan
Erschienen in
Annals of Nuclear Medicine / Ausgabe 8/2013
Print ISSN: 0914-7187
Elektronische ISSN: 1864-6433
DOI
https://doi.org/10.1007/s12149-013-0742-4

Weitere Artikel der Ausgabe 8/2013

Annals of Nuclear Medicine 8/2013 Zur Ausgabe

Original Article

Clinical significance of lung iodine-123 metaiodobenzylguanidine uptake assessment in Parkinson’s and heart diseases

Original Article

Prognostic implications of post-therapy 18F-FDG PET in patients with locoregionally advanced nasopharyngeal carcinoma treated with chemoradiotherapy

Case Report

Oncocytic carcinoid tumor of the lung with intense F-18 fluorodeoxyglucose (FDG) uptake in positron emission tomography–computed tomography (PET/CT)

Original Article

Do clinical characteristics and metabolic markers detected on positron emission tomography/computerized tomography associate with persistent disease in patients with in-operable cervical cancer?

Case Report

False-positive iodine-131 whole body scan due to a benign dermal lesion; intradermal nevus (131I uptake in a benign nevus)

Original Article

A new method for apparent diffusion coefficient measurement using sequential 18F-FDG PET and MRI: correlation with histological grade of invasive ductal carcinoma of the breast