A 18FDG PET/CT-based volume parameter is a predictor of overall survival in patients with local advanced gastric cancer

Objective: The present study investigated the prognosis value of preoperative fluorodeoxyglucose(FDG)positron emission tomography/computed tomography(PET/CT) in patients with local advanced gastric cancer(LAGC).Methods: In total, 144 patients [median age 63(range: 48-80) years old] with LAGC underwent 18 F-FDG PET/CT prior to any treatment. The maximum standardized uptake values(SUVmax), mean standardized uptake values(SUVmean), metabolic tumor volume(MTV) and total lesion glycolysis(TLG) of the primary lesion were measured on PET/CT and correlated with clinicopathological features and survival.Results: Significant differences in SUVmean, SUVmax, MTV and TLG were found according to Lauren’s classification, histologic grade and T category(P<0.05). During the 26.5-month follow-up, 51(35.4%) patients died and 70(48.6%) exhibited disease progression. The optimal thresholds of MTV and TLG were 15.1 cm^3 and 47.3 cm^3, respectively. The 3-year progression-free survival(PFS) and overall survival(OS) for patients with high TLG values were 30% and 38% compared to 38% and 47% for low TLG values, respectively(P<0.05). Univariate and multifactor analyses demonstrated that lymph node metastasis and T stage were independent prognostic factors for PFS;T stage, histologic grade and TLG were independent prognostic factors for OS(P<0.05). Molecular markers had no relationship with patient’s outcomes.Conclusions: Metabolic activity of primary gastric tumors from 18 F-FDG PET/CT is a prognostic factor in patients with LAGC.