Abstract
Background
Tumor recurrence is the leading cause of death after liver transplantation in patients with hepatocellular carcinoma. There is an ongoing debate as to whether metabolic indices such as tumor to liver standardized uptake value ratio in 18 F-fluorodeoxyglucose positron emission tomography/computed tomography of the primary tumor can identify patients outside the Milan criteria with as low recurrence rates as patients inside Milan and thus should be added to the established prognostic factors.
Methods
This retrospective study analyzes 103 consecutive patients who underwent 18 F fluorodeoxyglucose positron emission tomography/computed tomography before liver transplantation for hepatocellular carcinoma using data of clinical tumor registry. Primary endpoints were overall survival and 10-year cumulative recurrence rates.
Results
Tumor to liver standardized uptake value ratio of the primary tumor was statistically significant higher in Milan out tumors, “up-to-seven” out tumors, grade 3 tumors, alpha-fetoprotein level >400 ng/ml and lesions upwarts 5cm in diameter. Factors with statistically significant influence on the 10-year overall survival in the univariate analysis were Milan, up-to-seven” criteria, number of lesions and pT-category. COX regression analysis did not show independently statistically significant factors for 10-year overall survival. Milan, “up-to-seven” criteria, grade, pV, number of lesions, size of lesion, pT-category, tumor to liver standardized uptake value ratio influenced 10-year cumulative recurrence rates statistically significantly. Tumor to liver standardized uptake value ratio, grade and pT-category proved to be independently statistically significant factors for 10-year cumulative recurrence rates.
Conclusions
Our study suggests that tumor to liver standardized uptake value standardized uptake value ratio in 18 F-fluorodeoxyglucose positron emission tomography/computed tomography is an independent prognostic factor in transplanted patients with hepatocellular carcinoma and might be helpful in estimating the risk of recurrence for patients scheduled for liver transplantation.
Difference in prognostic values of maximal standardized uptake value on fluorodeoxyglucose-positron emission tomography and cyclooxygenase-2 expression between lung adenocarcinoma and squamous cell carcinoma
