Integration of low muscle mass into the IPS system and its prognostic significance in patients with Hodgkin's lymphoma

2021 ◽  
Author(s):  
Mahmut Bakir Koyuncu ◽  
Erkan Guler ◽  
Tolga Koseci ◽  
Mehmet Ali Ucar ◽  
Anil Tombak ◽  
...  
Keyword(s):  
Overall Survival ◽  
Muscle Mass ◽  
Operating Characteristic ◽  
Prognostic Score ◽  
Prognostic Significance ◽  
Psoas Muscle ◽  
Scoring Systems ◽  
Ct Scans ◽  
Pet Ct ◽  
International Prognostic Score

Aim: The aim of this study is to determine whether a novel prognostic score can be obtained by including low muscle mass in the international prognostic score (IPS) system. Materials & Methods: Psoas muscle areas were determined in the PET/CT scans of the patients taken for staging at the time of diagnosis and after two cycles of ABVD. After evaluating the effect of low muscle mass on overall survival, receiver operating characteristic (ROC) analyzes were performed by including it in IPS systems. Results: Overall survival was significantly lower in patients with low muscle mass. Adding low muscle mass to IPS scores increased AUC, sensitivity and specificity. Conclusion: The integration of low muscle mass into the IPS scoring systems increased the success of these systems in predicting a prognosis.

Psoas Cross-Sectional Area As Radiographic Measure Of Sarcopenia Does Not Predict Overall Survival In Multiple Myeloma

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 5326-5326
Author(s):  
Pavan Kumar Bhamidipati ◽  
Kenneth R Carson ◽  
Tanya M Wildes
Keyword(s):  
Multiple Myeloma ◽  
Overall Survival ◽  
Muscle Mass ◽  
Psoas Muscle ◽  
Cross Sectional Area ◽  
Whole Body ◽  
Sectional Area ◽  
Cross Sectional ◽  
Muscle Density ◽  
Pet Ct

Abstract Introduction Although various disease-related markers have been implemented in the prognosis of multiple myeloma, nutritional or physical characteristics have not been utilized in the assessment for prognosis. Sarcopenia, defined as loss of lean skeletal muscle mass, is prognostic in non-malignant diseases such as COPD and non-hematologic malignancies such as breast cancer and pancreatic cancer. For the first time, we sought to analyze the prognostic value of sarcopenia in multiple myeloma (MM) by utilizing PET / CT scans done around the time of diagnosis. Methods In this retrospective cohort study, we identified all patients diagnosed and treated for multiple myeloma from 2000-2010 from the Barnes-Jewish Hospital Oncology Data Services registry, then identified patients who had undergone cross-sectional imaging (CT or PET/CT) for diagnostic purposes within 2 months of diagnosis. Medical records were reviewed for clinical and anthropomorphic data. The radiographic images were accessed to manually measure the psoas muscle cross sectional area (PCA) at the level of 3rdlumbar vertebra (L3) by a single trained person. This landmark was chosen as the PCA at the level of L3 correlates with the whole–body lean muscle mass in previous studies (Mourtzakis M, 2008 PMID: 18923576).The psoas muscle density was identified based on the average CT Hounsfield units for the cross-sectional area being measured. This value was then normalized for stature based on height to calculate L3 muscle index (LMI)(Total Psoas Area (TPA), in cm2/m2). Overall survival was defined as the time from diagnosis to death from any cause, censored at last follow-up. Survival between tertiles of LMI was compared using the methods of Kaplan-Meier and the Log-Rank test. Results A total of 129 MM patients with radiographic imaging were identified (median age 61 years, range 32-91; 57% males; 66% white race, 31.8% black race). The median body mass index (BMI) was 28.7, range 16.6-49.9). Of the 93 patients with staging information available, 27% had ISS stage 1, 36.6% stage II, 36.6% stage III. The median OS for the entire cohort was 34.2 months (95% Confidence Intervals 23.5-45.0 months). Survival did not differ between the tertiles of LMI: median OS 26.9 months (95% CI 9.2-44.6) in lowest tertile of TPA, 54.1 months (95% CI 30.6-77.6) in middle tertile and 38.2 months in highest tertile [Log-rank c21.439, p=0.487]. We then evaluated psoas muscle density in the 56 patients who underwent abdominal CT imaging without intravenous contrast. Survival did not differ between the tertiles of psoas density: median OS 24.3 months (95% CI 10.3-38.2) in the lowest tertile, 33.8 months (95% CI 14.8-52.8) in middle tertile, and 44.8 months (95% CI 25.8 – 53.5) in the highest tertile, p=0.122. Conclusion Total psoas area and psoas density as a measure of sarcopenia did not predict overall survival in this cohort. Limitations of this study include the fact that patients underwent imaging for diagnostic purposes at clinician. Future study will evaluate whether radiographic measures of sarcopenia in a less selected MM population have prognostic utility. Disclosures: Carson: Spectrum Pharmaceuticals: Honoraria, Research Funding, Speakers Bureau.

scholarly journals Prognostic Role of Muscle Depletion in Palliative Care Patients With Incurable Cancer: A Retrospective Study

2020 ◽  
Author(s):  
Naoharu Mori ◽  
Keisuke Maeda ◽  
Yousuke Yamanaka ◽  
Remi Matsuyama ◽  
Tomoyuki Nonogaki ◽  
...  
Keyword(s):  
Palliative Care ◽  
Overall Survival ◽  
Muscle Mass ◽  
Performance Status ◽  
Prognostic Significance ◽  
Lumbar Vertebra ◽  
Psoas Muscle ◽  
University Hospital ◽  
Solid Cancer ◽  
Pinch Grip

Abstract Background: Depletion of muscle mass and strength has been proven to be a negative prognostic indicator for patients with cancer receiving anticancer treatment. However, little is known about its role in palliative care patients. The objective of this study was to evaluate the prognostic significance of muscle depletion in predicting survival among patients in palliative care.Methods: We retrospectively examined the association between muscle mass and strength and prognosis in patients with incurable solid cancer who are supported by a palliative care team at a university hospital. Psoas muscle index (PMI) at the level of the fourth lumbar vertebra was employed as the muscle mass index. Pinch grip strength (PGS) was used as the muscle strength index. Cox proportional hazards analysis was performed to evaluate the factors independently associated with overall survival.Results: A total of 78 patients were included in this study (35 male, median age 67 years). Median survival was 87.5 (95% confidence interval [CI] 50–124) days. After adjustment for age, sex, albumin, edema, and performance status as potential confounders, loss of PMI (HR=0.998, 95% CI 0.996–0.999; P=0.003) and PGS (HR=0.73, 95% CI 0.55–0.97; P=0.030) independently predicted the overall survival.Conclusion: Depletion of muscle mass and strength is an independent predictor of survival in patients with incurable solid cancer receiving palliative care. PMI and PGS may help to better assess the prognosis of patients in palliative care.

scholarly journals Sarcopenia Is a Negative Prognostic Factor in Patients Undergoing Transarterial Chemoembolization (TACE) for Hepatic Malignancies

Cancers ◽  
2019 ◽  
Vol 11 (10) ◽  
pp. 1503 ◽  
Author(s):  
Loosen ◽  
Schulze-Hagen ◽  
Bruners ◽  
Tacke ◽  
Trautwein ◽  
...  
Keyword(s):  
Overall Survival ◽  
Prognostic Factor ◽  
Muscle Mass ◽  
Transarterial Chemoembolization ◽  
Cox Regression ◽  
Psoas Muscle ◽  
Muscle Size ◽  
Rapid Decline ◽  
Term Outcome ◽  
Long Term Outcome

: Background and Aims: While transarterial chemoembolization (TACE) represents a standard of therapy for intermediate-stage hepatocellular carcinoma (HCC) and is also routinely performed in patients with liver metastases, it is still debated which patients represent the ideal candidates for TACE therapy in terms of overall survival. Sarcopenia, the degenerative loss of skeletal muscle mass and strength, has been associated with an adverse outcome for various malignancies, but its role in the context of TACE has largely remained unknown. Here, we evaluated the role of sarcopenia on the outcome of patients undergoing TACE for primary and secondary liver cancer. Methods: The patients’ psoas muscle size was measured on axial computed tomography (CT) scans and normalized for the patients’ height squared. This value was referred to as the psoas muscle index (PMI). The PMI was correlated with clinical and laboratory markers. Results: While pre-interventional sarcopenia had no impact on the direct tumor response to TACE, sarcopenic patients with a pre-interventional PMI below our ideal cut-off value of 13.39 mm/m2 had a significantly impaired long-term outcome with a median overall survival of 491 days compared to 1291 days for patients with a high PMI. This finding was confirmed by uni- and multivariate Cox-regression analyses. Moreover, a progressive rapid decline in muscle mass after TACE was a predictor for an unfavorable prognosis. Conclusion: Our data suggest that sarcopenia represents a previously unrecognized prognostic factor for patients undergoing TACE therapy which might yield important information on the patients’ post-interventional outcome and should therefore be implemented into clinical stratification algorithms.

Systemic inflammatory response in predicting survival in patients with operable colorectal cancer.

2011 ◽  
Vol 29 (4_suppl) ◽  
pp. 456-456 ◽  
Author(s):  
K. A. Kwon ◽  
S. Oh ◽  
S. Kim ◽  
S. Lee ◽  
J. Han ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Inflammatory Response ◽  
Survival Data ◽  
Prognostic Score ◽  
Prognostic Significance ◽  
Prognostic Index ◽  
Scoring Systems ◽  
Systemic Inflammatory Response ◽  
Lymphocyte Ratio

456 Background: Several inflammatory response materials could be biomarkers for prediction of prognosis of cancer patients; elevated C-reactive protein (CRP), increased white cell, neutrophil, platelet, and decreased albumin. The Glasgow Prognostic Score (GPS) combines circulating CRP and albumin level, the neutrophil/lymphocyte ratio (NLR), and the platelet/lymphocyte ratio (PLR) has been introduced for prognostic scoring system in colorectal cancer (CRC). Thus, in this study, we attempted to identify an more adequate prognostic model related with systemic inflammatory response for CRC. Methods: Between Mar 2005 and Dec 2008, 200 patients who underwent curative resection for colorectal cancer were enrolled in this study. Systemic inflammatory parameters (CRP, albumin, neutrophil, lymphocyte, and platelet count) were checked for making 3 scoring systems. Based on clinical survival data, we then compared PFS and OS with GPS, NLR, and PLR. Results: Male to female were 123:77. Median age of the patients was 64 years (range, 26-83 years). Median follow-up duration was 27.2 months (range 7.8-52.7 months). 36 patients were observed disease progression or death. 19 patients were passed away during follow-up duration. 3 year PFS and OS were 72% and 86%, respectively. Numbers of GPS 0,1, and 2 patients were 154 (77%), 44 (22%), and 2 (1%), respectively. Survival analysis according to GPS, PFS and OS could not be able to show the prognostic significance (P=0.313 and P=263). Cut-off value of NLR and PLR were determined 3 and 180 by ROC curve. Both of NLR and PLR were observed as a good prognostic biomarker of PFS and OS (P=0.009 and P<0.001 in PFS, P=0.006 and P=0.001 in OS). Conclusions: Although GPS, NLR, and PLR were introduced as prognostic scoring systems for operable CRC, PLR which is constructed of platelet/lymphocyte count may represent a useful prognostic index for the prediction of PFS and OS in operable CRC. No significant financial relationships to disclose.

Not All Positive Interim PET/CT Scans Are Reliably Predictive for Progression Free Survival in Hodgkin Lymphoma (HL) Patients. A Proposed Model for a Functional Scoring Scale.

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 1452-1452
Author(s):  
Eldad J. Dann ◽  
Ada Tamir ◽  
Ron Epelbaum ◽  
Irit Avivi ◽  
Menachem Ben-Shachar ◽  
...  
Keyword(s):  
Scoring System ◽  
Progression Free Survival ◽  
Scoring Systems ◽  
Ct Scans ◽  
Free Survival ◽  
Residual Mass ◽  
Fdg Uptake ◽  
Interim Pet ◽  
Visual Scoring ◽  
Pet Ct

Abstract Interim PET-CT is used to predict the progression-free survival in HL (Gallamini, JCO 2007). However, what constitutes a functionally positive interim PET-CT has not been established. Does a single focus of reduced residual uptake predict and justify an escalation of therapy? In this study, 96 patients [47 females, 49 males; median age 30 (17–57) years] with HL (stage I -3, II- 50, III-18, IV-25), treated at the Rambam Medical Center (Haifa, Israel) since 2001 were evaluated. Prior to the interim PET, patients received 2 cycles of ABVD (33) or BEACOPP (41) or escalated BEACOPP (EB) (22). While an interim PET-CT was performed on all patients, only patients receiving BEACOPP had a planned escalation or reduction of therapy (for the escalated BEACOPP group) following the interim PET-CT as part of the protocol. The 4-year progression-free survival (PFS) and overall survival (OS) of 96 HL patients were better for negative interim PET-CT (93% and 98%) than for positive studies. The analysis for predictive PFS, by PET-CT is based on a static binary score which defines response depending on the presence or absence of any abnormal uptake on interim study. Thus, 24 patients had a positive interim PET-CT, in 11 of whom, the therapy was escalated and 3 had continued therapy with EB. Three patients in the escalated group and two who were not escalated progressed. Nineteen of the 24 patients with a positive interim PET responded fully. However, not all positive PET-CT scans were the same; there was a difference in the number of residual sites and intensity, which led us to propose the following functional model as outlined in Table 1. Table 1. Dynamic Scoring of PET-CT for Interim Analysis of HL Score # of residual foci: compared with baseline Intensity of uptake 0 0 0 1 1 reduced 2 &gt;1 but less than baseline reduced 3 unchanged reduced 4 unchanged or increased number same or increased This model was compared with the scoring system suggested by the Consensus of the Imaging Subcommittee (Juweid, JCO 2007) where any residual mass &lt; 2cm with an abnormal FDG uptake, a residual mass ≥ 2 cm, or an abnormal FDG uptake moderately increased above that of the mediastinum are considered positive. In the proposed dynamic model, patients with an interim PET-CT score of 0–2 are functionally similar; a PET-CT with a positive predictive value would only be a score of 3 or greater. The results of using this model for all the 96 patients are presented in Table 2. Of note, the specificity of the current model was significantly better than in both static scoring systems (p = 0.0001). Table 2. Comparison of PET-CT Performance by 3 Scoring Systems Performance Static visual assessment % (n) Scoring system: Consensus Imaging Subcommittee % (n) Visual dynamic score: current study % (n) PPV 21% (5/24) 19% (4/21) 50% (3/6) NPV 94% (68/72) 93% (70/75) 93% (84/90) Sensitivity 55% (5/9) 44% (4/9) 33% (3/9) Specificity 78% (68/87) 80% (70/87) 96% (84/87) In conclusion: Interim PET-CT is a useful tool for predicting prognosis in patients with HL. A dynamic visual scoring method, which reflects the functional dynamics of response in comparison to pre-treatment findings, may be a better indicator of resistant disease than static visual scoring systems. Based on the model proposed, a score of ≥3 should be considered as a cutoff point. Such a model needs to be prospectively validated in larger clinical trials.

scholarly journals The Combination of Low Skeletal Muscle Mass and High Tumor Interleukin-6 Associates with Decreased Survival in Clear Cell Renal Cell Carcinoma

Cancers ◽  
2020 ◽  
Vol 12 (6) ◽  
pp. 1605
Author(s):  
Joshua K. Kays ◽  
Leonidas G. Koniaris ◽  
Caleb A. Cooper ◽  
Roberto Pili ◽  
Guanglong Jiang ◽  
...  
Keyword(s):  
Gene Expression ◽  
Skeletal Muscle ◽  
Overall Survival ◽  
Muscle Mass ◽  
Interleukin 6 ◽  
Skeletal Muscle Mass ◽  
Clear Cell ◽  
Cytokine Gene Expression ◽  
Ct Scans ◽  
Adipose Mass

Clear cell renal carcinoma (ccRCC) is frequently associated with cachexia which is itself associated with decreased survival and quality of life. We examined relationships among body phenotype, tumor gene expression, and survival. Demographic, clinical, computed tomography (CT) scans and tumor RNASeq for 217 ccRCC patients were acquired from the Cancer Imaging Archive and The Cancer Genome Atlas (TCGA). Skeletal muscle and fat masses measured from CT scans and tumor cytokine gene expression were compared with survival by univariate and multivariate analysis. Patients in the lowest skeletal muscle mass (SKM) quartile had significantly shorter overall survival versus the top three SKM quartiles. Patients who fell into the lowest quartiles for visceral adipose mass (VAT) and subcutaneous adipose mass (SCAT) also demonstrated significantly shorter overall survival. Multiple tumor cytokines correlated with mortality, most strongly interleukin-6 (IL-6); high IL-6 expression was associated with significantly decreased survival. The combination of low SKM/high IL-6 was associated with significantly lower overall survival compared to high SKM/low IL-6 expression (26.1 months vs. not reached; p < 0.001) and an increased risk of mortality (HR = 5.95; 95% CI = 2.86–12.38). In conclusion, tumor cytokine expression, body composition, and survival are closely related, with low SKM/high IL-6 expression portending worse prognosis in ccRCC.

scholarly journals Prognostic value of low skeletal muscle mass in patient treated by exclusive curative radiochemotherapy for a NSCLC

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
R. Mallet ◽  
P. Decazes ◽  
R. Modzelewski ◽  
J. Lequesne ◽  
P. Vera ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Overall Survival ◽  
Prognostic Factor ◽  
Muscle Mass ◽  
Body Mass ◽  
Visceral Fat ◽  
Prognostic Value ◽  
Skeletal Muscle Mass ◽  
Pet Ct ◽  
Cox Analysis

AbstractLow skeletal muscle mass is a well-known prognostic factor for patients treated for a non-small-cell lung cancer by surgery or chemotherapy. However, its impact in patients treated by exclusive radiochemotherapy has never been explored. Our study tries to evaluate the prognostic value of low skeletal muscle mass and other antropometric parameters on this population. Clinical, nutritional and anthropometric date were collected for 93 patients treated by radiochemotherapy for a NSCLC. Anthropometric parameters were measured on the PET/CT by two methods. The first method was a manual segmentation at level L3, used to define Muscle Body Area (MBAL3), Visceral Fat Area (VFAL3) and Subcutaneous Fat Area (SCFAL3). The second method was an software (Anthropometer3D), allowing an automatic multislice measurement of Lean Body Mass (LBMAnthro3D), Fat Body Mass (FBMAnthro3D), Muscle Body Mass (MBMAnthro3D), Visceral Fat Mass (VFMAnthro3D), and Sub-Cutaneous Fat Mass (SCFMAnthro3D) on the PET/CT. All anthropometrics parameters were normalised by the patient's height. The primary end point was overall survival time. Univariate and then stepwise multivariate cox analysis were performed for significant parameters. Finally, Spearman's correlation between MBAL3 and MBMAnthro3D was assessed. Forty-one (44%) patients had low skeletal muscle mass. The median overall survival was 18 months for low skeletal muscle mass patients versus 36 months for non-low skeletal muscle mass patients (p = 0.019). Low skeletal muscle mass (HR = 1.806, IC95% [1.09–2.98]), serums albumin level < 35 g/l (HR = 2.203 [1.19–4.09]), Buzby Index < 97.5 (HR = 2.31 [1.23–4.33]), WHO score = 0 (HR = 0.59 [0.31–0.86] and MBMAnthro3D < 8.56 kg/m2 (HR = 2.36 [1.41–3.90]) were the only significant features in univariates analysis. In the stepwise multivariate Cox analysis, only MBMAnthro3D < 8.56 kg/m2 (HR = 2.16, p = 0.003) and WHO score = 0 (HR = 0.59, p = 0.04) were significant. Finally, muscle quantified by MBAL3 and MBMAnthro3D were found to be highly correlated (Spearman = 0.9). Low skeletal muscle mass, assessed on the pre-treatment PET/CT is a powerful prognostic factor in patient treated by radiochemotherapy for a NSCLC. The automatic software Anthropometer3D can easily identify patients a risk that could benefit an adapted therapy.

Towards a Comprehensive Prognostic Score in CLL Based On a Combination of Genetic Parameters.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 1234-1234
Author(s):  
Claudia Haferlach ◽  
Frank Dicker ◽  
Tamara Weiss ◽  
Susanne Schnittger ◽  
Christian Beck ◽  
...  
Keyword(s):  
Overall Survival ◽  
Chromosome Aberrations ◽  
Prognostic Score ◽  
Prognostic Significance ◽  
Rank Test ◽  
Prognostic Impact ◽  
Time To Treatment ◽  
Log Rank Test ◽  
Equity Ownership ◽  
The Impact

Abstract Abstract 1234 Poster Board I-256 CLL is a heterogeneous disease with a variable clinical course. In this study the prognostic power of chromosome banding analysis (CBA), interphase FISH and IgVH status was evaluated. In total 399 untreated cases were analyzed. First, we could confirm the prognostic significance of established parameters such as age (≥65 yrs), white blood cell count (≥20.000/μl), IgVH status, TP53 deletion and 11q deletion in our cohort. In addition, a negative prognostic impact of translocations involving the IgH locus, especially t(14;18)(q32;q21) and of the complexity of the karyotype measured by the number of clonal chromosome aberrations in CBA was observed. Furthermore it became obvious that some parameters discriminated better for overall survival and other for time to treatment. While the impact of the IgVH status on overall survival was low within the first 5 years after diagnosis (mutated 88.5% surviving vs unmutated 82.0% surviving, log rank test p=0.022), an unmutated IgVH status was strongly correlated with a shorter median time to treatment (18.3 months unmutated vs 110.7 months mutated, log rank test p<0.0001). On the other hand the impact of TP53 deletion was more pronounced on overall survival as compared to time to treatment. Age was associated with a shorter overall survival but was not significantly associated with time to treatment. Based on these results we propose a score for overall survival (OS) based on: age ≥65 yrs, WBC ≥20.000/μl, unmutated IgVH status, TP53 deletion, t(IgH), and the number of chromosome aberrations observed in CBA. Three respective risk groups showed considerable differences in OS (94.5% vs 64.3% vs 41.1% surviving at 5 yrs, p<0.0001). In contrast, time to treatment (TTT) was predicted best by unmutated IgVH status, ATM deletion, t(IgH) and number of chromosome aberrations. Four subgroups could be separated with median TTT of 110.7 months, 39.8 months, 19.5 months, and 3.8 months, respectively (p<0.0001). In conclusion, our data show that in combination with established prognostic markers such as an unmutated IgVH status, TP53/17p deletions or 11q deletions also the newly defined complexity of the karyotype measured by the number of chromosome aberrations has an important impact both on overall survival and also on time to treatment in CLL. These newly combined parameters translate into a more distinct separation of prognostic subgroups within the first years after diagnosis as compared to other prognostic systems using FISH data only or based on FISH data in combination with IgVH status. Prospective studies should evaluate the power for early stage CLL patients. Disclosures Haferlach: MLL Munich Leukemia Laboratory: Equity Ownership. Dicker:MLL Munich Leukemia Laboratory: Employment. Weiss:MLL Munich Leukemia Laboratory: Employment. Schnittger:MLL Munich Leukemia Laboratory: Equity Ownership. Kern:MLL Munich Leukemia Laboratory: Equity Ownership. Haferlach:MLL Munich Leukemia Laboratory: Equity Ownership.

Prognostic Significance Of Positron Emission Tomography-Computed Tomography In Patients With Marginal Zone Lymphoma

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 4324-4324
Author(s):  
Cheolwon Suh ◽  
Ji Hyun Park ◽  
Dok Hyun Yoon ◽  
Jooryung Huh ◽  
Jin Sook Ryu ◽  
...  
Keyword(s):  
Ct Scan ◽  
Marginal Zone ◽  
Prognostic Significance ◽  
Post Treatment ◽  
Emission Tomography ◽  
Ct Scans ◽  
Interim Pet ◽  
Positron Emission ◽  
Pet Ct ◽  
Pet Ct Scan

Abstract Background & Aims 18F-fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET-CT) scan has been increasingly used for initial staging and response evaluation in patients with lymphomas, and its clinical utility is well established in Hodgkin’s lymphoma (HL) as well as in diffuse large B-cell lymphoma (DLBCL) and follicular lymphoma (FL). However, its role remains undetermined in marginal zone lymphomas (MZL), due to its relatively low FDG avidity as well as small numbers of patients in the Western countries although it is the most common type of indolent lymphoma in Korea. Thus, we aimed to assess the prognostic significance of PET-CT scan performed after first-line therapy in patients with MZL. Patients & Methods We retrospectively reviewed the medical records of a total of 194 patients with pathologically confirmed MZL in the Asan Medical Center between February 2003 and February 2011. Post-treatment FDG PET-CT scan was defined as which performed during the periods of 2 to 4 weeks after the completion of chemotherapy or 7 to 9 weeks after radiotherapy. Among them, we identified 32 patients with evaluable pretreatment, interim and post-treatment PET-CT scans who received chemotherapy. We investigated the prognostic significance of maximum standardized uptake value (SUVmax) at pretreatment PET-CT and metabolic complete response (mCR) at post-treatment PET-CT. The log-rank test was used to assess the correlation of event-free survival (EFS) and overall survival (OS) with baseline SUVmax or the presence of mCR. All categorical variables were analyzed using Chi-square test or Fisher’s exact test. Results In a total of analyzable 32 patients, histopathologic subtypes of them were as follow: Mucosa-associated lymphoid tissue (MALT) lymphoma (n=14, 43.8%), nodal MZL (n=17, 53.1%), and splenic MZL (n=1, 3.2%). The median SUVmax in pretreatment PET-CT was 5.3 (range, 1.3 – 18.8). There were no significant associations of SUVmax (cutoff: 5.3) at pretreatment PET-CT to mCR in both post-treatment and interim PET-CT scans (p =0.694 and p=0.723, respectively). However, high SUV group (SUVmax at baseline PET-CT >5.3) showed inferior 5-year EFS and OS to low SUV group (¡Â 5.3) with marginal statistical significicance (p=-0.072 and p=0.101, respectively). With a median follow-up duration of 41 months (range, 9 to 99 months), 5-year OS and EFS rate were 87.9% and 43.9%, respectively. 5-year EFS was significantly superior in patients who attained mCR at post-treatment PET-CT (p =0.010, 55.0% to 0%), and also in interim PET-CT (p=0.007, 70.6% to 13.1%). In addition, patients who attained early mCR showed significantly better 5-year EFS than patients of delayed and never mCR groups (p=0.011, 70.6% to 22.5%, and 0%). Conclusion In our study cohort, patients with low SUVmax (¡Â 5.3) in pretreatment PET-CT showed strong trends of superior EFS and OS. More importantly, early attained mCR and mCR at post-treatment PET-CT were independent predictors of higher 5-year EFS rates. Disclosures: No relevant conflicts of interest to declare.

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