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dc.contributor.authorLau, Lawrence Fen
dc.contributor.authorWilliams, David Sen
dc.contributor.authorLee, Sze Tingen
dc.contributor.authorScott, Andrew Men
dc.contributor.authorChristophi, Christopheren
dc.contributor.authorMuralidharan, Vijayaragavanen
dc.identifier.citationAnnals of Surgical Oncology 2014; 21(7): 2420-8en
dc.description.abstractBiological characteristics of colorectal cancer liver metastases (CRCLM) are increasingly recognized as major determinants of patient outcome. The purpose of this study was to evaluate the prognostic value of metabolic response to preoperative chemotherapy as quantified by (18)F-FDG positron emission tomography (PET) for patients undergoing liver resection of CRCLM.All patients (n = 80) who had staging PET before liver resection for CRCLM at Austin Health in Melbourne between 2004 and 2011 were included. Thirty-seven patients had PET and CT imaging before and after preoperative chemotherapy. Semiquantitative PET parameters-maximum standardized uptake variable (SUVmax), metabolic tumour volume (MTV), and total glycolytic volume (TGV)-were derived. Metabolic response was determined by the proportional change in PET parameters (∆SUVmax, ∆MTV, ∆TGV). Prognostic scores, CT RECIST response, and tumour regression grading (TRG) were also assessed. Correlation to recurrence-free (RFS) and overall survival (OS) was assessed using Kaplan-Meier survival and multivariate analysis.Semiquantitative parameters on staging PET before chemotherapy were not predictive of prognosis, whereas all parameters after chemotherapy were prognostic for RFS and OS. Only ∆SUVmax was predictive of RFS and OS on multivariate analysis. Patients with metabolically responsive tumours had an OS of 86 % at 3 years vs. 38 % with nonresponsive or progressive tumours (p = 0.003). RECIST and TRG did not predict outcome.Tumour metabolic response to preoperative chemotherapy as quantified by PET is predictive of prognosis in patients undergoing resection of CRCLM. Assessing metabolic response uniquely characterizes tumour biology, which may allow future optimization of patient and treatment selection.en
dc.subject.otherAged, 80 and overen
dc.subject.otherAntineoplastic Combined Chemotherapy Protocols.therapeutic useen
dc.subject.otherColorectal Neoplasms.metabolism.mortality.pathology.therapyen
dc.subject.otherCombined Modality Therapyen
dc.subject.otherFluorodeoxyglucose F18.diagnostic useen
dc.subject.otherFluorouracil.administration & dosageen
dc.subject.otherFollow-Up Studiesen
dc.subject.otherLeucovorin.administration & dosageen
dc.subject.otherLiver Neoplasms.metabolism.mortality.secondary.therapyen
dc.subject.otherMiddle Ageden
dc.subject.otherNeoplasm Stagingen
dc.subject.otherOrganoplatinum Compounds.administration & dosageen
dc.subject.otherPositron-Emission Tomographyen
dc.subject.otherProspective Studiesen
dc.subject.otherROC Curveen
dc.subject.otherRadiopharmaceuticals.diagnostic useen
dc.subject.otherSurvival Rateen
dc.subject.otherTomography, X-Ray Computeden
dc.subject.otherYoung Adulten
dc.titleMetabolic response to preoperative chemotherapy predicts prognosis for patients undergoing surgical resection of colorectal cancer metastatic to the liver.en
dc.typeJournal Articleen
dc.identifier.journaltitleAnnals of surgical oncologyen
dc.identifier.affiliationDepartment of Surgery, Austin Hospital, University of Melbourne, Heidelberg, VIC, Australia,en
dc.type.austinJournal Articleen, Christopher
item.openairetypeJournal Article-
item.fulltextWith Fulltext-
item.grantfulltextopen- (University of Melbourne)- Newton-John Cancer Research Institute- Imaging and Therapy- Imaging and Therapy- Newton-John Cancer Research Institute- Surgery- (University of Melbourne)- Surgery-
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