A hierarchical prognostic model for risk stratification in patients with early breast cancer according to ¹⁸F‐fludeoxyglucose uptake and clinicopathological parameters

Abstract

This study was to investigate a hierarchical prognostic model using clinicopathological factors and 18F‐fludeoxyglucose (FDG) uptake on positron emission tomography/computed tomography (PET/CT) for recurrence‐free survival (RFS) in patients with early breast cancer who underwent surgery without neoadjuvant chemotherapy. A total of 524 patients with early breast cancer were included. The Cox proportional hazards model was used with clinicopathological variables and maximum standardized uptake value (SUVmax) on PET/CT. After classification and regression tree (CART) modeling, RFS curves were estimated using the Kaplan–Meier method and differences in each risk layer were assessed using the log‐rank test. During a median follow‐up of 46.2 months, 31 (5.9%) patients experienced recurrence. The CART model identified four risk layers: group 1 (SUVmax ≤6.75 and tumor size ≤2.0 cm); group 2 (SUVmax ≤6.75 and Luminal A [LumA] or TN tumor >2.0 cm); group 3 (SUVmax ≤6.75 and Luminal B [LumB] or human epidermal growth factor receptor 2 [HER2]‐enriched] tumor >2.0 cm); group 4 (SUVmax >6.75). Five‐year RFS was as follows: 95.9% (group 1), 98% (group 2), 82.8% (group 3), and 85.4% (group 4). Group 3 or group 4 showed worse prognosis than group 1 or group 2 (group 1 vs. group 3: P = 0.040; group 1 vs. group 4: P < 0.001; group 2 vs. group 3: P = 0.016; group 2 vs. group 4: P < 0.001). High SUVmax (>6.75) in primary breast cancer was an independent factor for poor RFS. In patients with low SUVmax, LumB or HER2‐enriched tumor >2 cm was also prognostic for poor RFS, similar to high SUVmax.

The Prognostic Value of 18F-FDG Uptake in the Supraclavicular Lymph Node (N3c) on PET/CT in Patients With Locally Advanced Breast Cancer With Clinical N3c

“…Interestingly, despite its lower prevalence, the luminal subtype showed similar recurrence to other subtypes, which is different from early breast cancer in which the luminal subtype showed less recurrence compared with the HER2-enriched and TN subtypes. 26 In this study, we found recurrence in 13/28 (46%) with luminal, 3/9 (33%) with HER2-enriched, and 7/18 (39%) with TN subtypes.…”

Prognostic value of maximum standard uptake value, metabolic tumor volume, and total lesion glycolysis of positron emission tomography/computed tomography in patients with breast cancer: A systematic review and meta-analysis

“…After excluding duplications and meeting summaries, 69 articles that did not meet the inclusion criteria were removed. Finally, 20 studies including 3,115 patients that met the conditions of the study and published from 2013 to 2019 were included in this meta-analysis[6, 7, 9, 11–27] (Fig 1). All 20 studies reported the prognostic values of SUVmax, MTV or TLG for BC survival.…”

Prognostic value of the metabolic score obtained via [18F]FDG PET/CT and a new prognostic staging system for gastric cancer

“…Two recent studies developed a prognostic model using [ 18 F]FDG PET/CT parameters for hepatocellular carcinoma and breast cancer 23 , 24 ; however, a prognostic model using a combination of T_SUVmax and N_SUVmax has not been reported for GC. Accordingly, we developed and internally validated a new staging system that comprises a combination of the metabolic score and the conventional TNM stage, which are independent prognostic factors for DSS in GC patients.…”