title: Clinical implication of FDG-PET in advanced gastric cancer with signet ring cell histology.
abstract: OBJECTIVE
  The purpose of this study was to investigate the role of the standardized uptake values (SUV), a semi-quantitative assessment of tumor FDG uptake, as a prognosticator for advanced signet ring cell carcinoma (SRC).
  
  
  METHODS
  We reviewed the files of 41 patients who underwent curative gastrectomy for advanced SRC and who had an FDG-PET at initial presentation between September 2003 and December 2007.
  
  
  RESULTS
  The median follow-up period was 30.9 months (range: 4.0-70.3). We found a correlation between the SUVmax and TNM stage. When the patients were divided into two groups (low vs. high SUVmax) based on a median SUVmax of 3.80, the high-SUVmax group showed more aggressive tumor behavior than did the low SUVmax group. In addition, the high SUVmax group showed more postoperative recurrence (P = 0.028), shorter relapse-free survival (P = 0.004), and lower 30-month cancer-specific survival rates (40.0% vs. 69.3%, P = 0.008). However, in multivariate analysis, SUVmax failed to be an independent predictor of overall survival.
  
  
  CONCLUSIONS
  Although SUVmax of initial PET scan was not an independent predictor of patient outcomes after curative surgery, higher SUVmax is associated with more advanced stage and indicates more aggressive tumor biology in advanced SRC.
authors.affiliation: Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Kyung Ho
authors.initials: KH
authors.lastname: Pak
authors.forename: Mijin
authors.initials: M
authors.lastname: Yun
authors.forename: Jae-Ho
authors.initials: JH
authors.lastname: Cheong
authors.forename: Woo Jin
authors.initials: WJ
authors.lastname: Hyung
authors.forename: Seung Ho
authors.initials: SH
authors.lastname: Choi
authors.forename: Sung Hoon
authors.initials: SH
authors.lastname: Noh
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018279:Carcinoma, Signet Ring Cell / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D005260:Female; D019788:Fluorodeoxyglucose F18; D005500:Follow-Up Studies; D005743:Gastrectomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D013274:Stomach Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18