Prognostic value of 18F-FDG PET for hepatocellular carcinoma patients treated with sorafenib
Version of Record online: 3 MAY 2011
© 2011 John Wiley & Sons A/S
Volume 31, Issue 8, pages 1144–1149, September 2011
How to Cite
Lee, J. H., Park, J. Y., Kim, D. Y., Ahn, S. H., Han, K.-H., Seo, H. J., Lee, J. D. and Choi, H. J. (2011), Prognostic value of 18F-FDG PET for hepatocellular carcinoma patients treated with sorafenib. Liver International, 31: 1144–1149. doi: 10.1111/j.1478-3231.2011.02541.x
- Issue online: 7 AUG 2011
- Version of Record online: 3 MAY 2011
- Received 21 January 2011, Accepted 6 April 2011
- 18F-FDG PET;
- hepatocellular carcinoma;
Background: Sorafenib (Nexavar) is an orally active multikinase inhibitor that is approved for the treatment of hepatocellular carcinoma (HCC). In this study, we used 18F-2-fluoro-2-deoxyglucose (18F-FDG) with positron emission tomography (PET) to predict the treatment outcome of sorafenib in patients with advanced HCC.
Materials and methods: A total of 29 patients with HCC were included. Baseline 18F-FDG PET scans were performed a median of 14 days before sorafenib treatment. Sorafenib was administered orally at a dose of 400 mg twice daily. For statistical analysis, the standardized uptake value (SUV) of the most hypermetabolic lesion was obtained and assigned as the SUVmax for each patient.
Results: Among 29 patients, one patient achieved partial remission and 14 patients showed stable disease. The overall survival (OS) and progression free survival (PFS) were 5.1 months [95% confidence interval (CI): 0.0–12.0] and 3.8 months (95% CI: 1.4–6.2). The multivariate analysis of OS showed that four indices, Eastern Cooperative Oncology Group performance status, α-fetoprotein (AFP) concentration, portal vein thrombosis and SUVmax were significant prognostic factors (P=0.030, P=0.024, P=0.020 and P=0.015 respectively). AFP concentration and SUVmax were independent prognostic factors for PFS, too (P=0.003 and P=0.026 respectively). When the patients were divided into two groups: low SUVmax (n=10; <5.00) and high SUVmax (n=19;≥5.00), the low SUV group showed significantly longer OS and PFS (P=0.023 and P=0.042 respectively).
Conclusion: Our study showed that the degree of FDG uptake is an independent prognostic factor in patients with HCC who undergo sorafenib treatment.