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Arikan R, Ozguven S, Telli TA, Isik S, Demircan NC, Basoglu T, Yasar A, Celebi A, Filizoglu N, Ustun HS, Tinay I, Ones T, Turoglu HT, Erdil TY, Ozturk MA, Ercelep O, Bayoglu V, Kostek O, Dane F, Yumuk PF. Prognostic significance of 18F-FDG PET/CT indices in metastatic renal cell cancer and evaluation of revised IMDC risk model by including 18F-FDG PET-CT parameters. Acta Radiol 2022; 64:2040-2049. [PMID: 36447438 DOI: 10.1177/02841851221140504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Background Prognostic markers in metastatic renal cell cancer (mRCC) are still insufficient. Any prognostic model objectively determines disease burden. Purpose To investigate the relationship between 18-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) parameters and outcomes in mRCC, and to define a revised International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) model for the intermediate-risk group. Material and Methods A retrospective study of mRCC was conducted. To investigate the prognostic significance of 18F-FDG PET/CT parameters, maximum standardized uptake value (SUVmax), total lesion glycolysis (TLG), and metabolic tumor volume (MTV) were determined in pre-treatment images. Cutoff values were defined by ROC curve analyses and their association with outcomes was analyzed. Additionally, a TLG-adjusted IMDC model was created by stratifying intermediate-risk group patients according to TLG levels. Results The study included 52 patients. The disease control rate (DCR) was 61.5% and median overall survival (OS) was 18 months (95% confidence interval=9.2–25.8). In the univariate analyses, IMDC score, MTV, and TLG were prognostic factors for Disease Control Rate (DCR), and Eastern Cooperative Oncology Group (ECOG)-Performance Status (PS), IMDC score, lactate dehydrogenase (LDH), treatment option, MTV, and TLG were prognostic factors for OS ( P < 0.05 each). In the multivariate analyses, MTV was an independent prognostic factor for DCR, and ECOG-PS, LDH, IMDC score, and TLG were independent prognostic factors for OS. According to the revised-IMDC model, the intermediate-favorable group showed longer OS than the intermediate-unfavorable group. Conclusion Pretreatment MTV was independent prognostic factor for DCR and ECOG-PS, LDH, IMDC score, and TLG were independent prognostic factors for OS. Revised-IMDC model could identify patients with a worse prognosis among the IMDC intermediate-risk group.
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Affiliation(s)
- Rukiye Arikan
- Department of Internal Medicine, Division of Medical Oncology, Marmara University School of Medicine, Istanbul, Turkey
| | - Salih Ozguven
- Department of Nuclear Medicine, Marmara University School of Medicine, Istanbul, Turkey
| | - Tugba Akin Telli
- Department of Internal Medicine, Division of Medical Oncology, Marmara University School of Medicine, Istanbul, Turkey
| | - Selver Isik
- Department of Internal Medicine, Division of Medical Oncology, Marmara University School of Medicine, Istanbul, Turkey
| | - Nazım Can Demircan
- Department of Internal Medicine, Division of Medical Oncology, Marmara University School of Medicine, Istanbul, Turkey
| | - Tugba Basoglu
- Department of Internal Medicine, Division of Medical Oncology, Marmara University School of Medicine, Istanbul, Turkey
| | - Alper Yasar
- Department of Internal Medicine, Division of Medical Oncology, Marmara University School of Medicine, Istanbul, Turkey
| | - Abdussamet Celebi
- Department of Internal Medicine, Division of Medical Oncology, Marmara University School of Medicine, Istanbul, Turkey
| | - Nuh Filizoglu
- Department of Nuclear Medicine, Marmara University School of Medicine, Istanbul, Turkey
| | - Hilal Sagiroglu Ustun
- Department of Internal Medicine, Marmara University School of Medicine, Istanbul, Turkey
| | - Ilker Tinay
- Department of Urology, Marmara University School of Medicine, Istanbul, Turkey
| | - Tunc Ones
- Department of Nuclear Medicine, Marmara University School of Medicine, Istanbul, Turkey
| | - Halil Turgut Turoglu
- Department of Nuclear Medicine, Marmara University School of Medicine, Istanbul, Turkey
| | - Tanju Yusuf Erdil
- Department of Nuclear Medicine, Marmara University School of Medicine, Istanbul, Turkey
| | - Mehmet Akif Ozturk
- Department of Internal Medicine, Division of Medical Oncology, Bahcesehir University School of Medicine, Istanbul, Turkey
| | - Ozlem Ercelep
- Department of Internal Medicine, Division of Medical Oncology, Marmara University School of Medicine, Istanbul, Turkey
| | - Vedat Bayoglu
- Department of Internal Medicine, Division of Medical Oncology, Marmara University School of Medicine, Istanbul, Turkey
| | - Osman Kostek
- Department of Internal Medicine, Division of Medical Oncology, Marmara University School of Medicine, Istanbul, Turkey
| | - Faysal Dane
- Department of Internal Medicine, Division of Medical Oncology, Acıbadem University School of Medicine, Istanbul, Turkey
| | - Perran Fulden Yumuk
- Department of Internal Medicine, Division of Medical Oncology, Koc University School of Medicine, Istanbul, Turkey
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