title: Clinical significance of metabolic tumor volume by PET/CT in stages II and III of diffuse large B cell lymphoma without extranodal site involvement.
abstract: The objective of this study was to investigate whether metabolic tumor volume (MTV) by positron emission tomography (PET) can be a potential prognostic tool when compared with Ann Arbor stage, in stages II and III nodal diffuse large B cell lymphoma (DLBCL). We evaluated 169 patients with nodal stages II and III DLBCL who underwent measurements with PET prior to rituximab combined with cyclophosphamide, adriamycin, vincristine, and prednisone (R-CHOP). Cutoff point of MTV was measured using the receiver operating characteristic (ROC) curve. During a median period of 36 months, stage II was 59.2% and III was 40.8%. Using the ROC curve, the MTV of 220 cm(3) was the cutoff value. The low MTV group (<220 cm(3)) had longer progression-free survival (PFS) and overall survival (OS), compared with the high MTV group (≥220 cm(3)) (p < 0.001, p < 0.001). Stage II patients had longer survival than those in stage III (PFS, p = 0.011; OS, p = 0.001). The high MTV group had lower PFS and OS patterns, regardless of stage, compared with the low MTV group (p < 0.001, p < 0.001). Multivariate analysis revealed an association of the high MTV group with lower PFS and OS (PFS, hazard ratio (HR) = 5.300, p < 0.001; OS, HR = 7.009, p < 0.001), but not stage III (PFS, p = 0.187; OS, p = 0.054). Assessment of MTV by PET had more potential predictive power than Ann Arbor stage in the patients that received R-CHOP.
authors.affiliation: Department of Hematology-Oncology, Busan Cancer Center, Pusan National University Hospital Medical Research Institute, 1-10 Ami-dong, Seo-gu, Busan, 602-739, Republic of Korea.
authors.forename: Moo-Kon
authors.initials: MK
authors.lastname: Song
authors.affiliation: Department of Hematology-Oncology, Busan Cancer Center, Pusan National University Hospital Medical Research Institute, 1-10 Ami-dong, Seo-gu, Busan, 602-739, Republic of Korea. Hemon@pusan.ac.kr.
authors.forename: Joo-Seop
authors.initials: JS
authors.lastname: Chung
authors.affiliation: Department of Hematology-Oncology, Busan Cancer Center, Pusan National University Hospital Medical Research Institute, 1-10 Ami-dong, Seo-gu, Busan, 602-739, Republic of Korea.
authors.forename: Ho-Jin
authors.initials: HJ
authors.lastname: Shin
authors.affiliation: Department of Hematology-Oncology, Busan Paik Hospital, Busan, South Korea.
authors.forename: Sang-Min
authors.initials: SM
authors.lastname: Lee
authors.affiliation: Department of Hematology, Dong-A University Medical Center, Busan, South Korea.
authors.forename: Su-Ee
authors.initials: SE
authors.lastname: Lee
authors.affiliation: Department of hematology, Kosin University Gospel Hospital, Busan, South Korea.
authors.forename: Ho-Sup
authors.initials: HS
authors.lastname: Lee
authors.affiliation: Department of hematology, Gyeongsang National University Hospital, Jinju, South Korea.
authors.forename: Gyeong-Won
authors.initials: GW
authors.lastname: Lee
authors.affiliation: Department of Nuclear Medicine, Pusan National University Hospital, Busan, South Korea.
authors.forename: Seong-Jang
authors.initials: SJ
authors.lastname: Kim
authors.affiliation: Department of Nuclear Medicine, Busan Paik Hospital, Busan, South Korea.
authors.forename: Seok-Mo
authors.initials: SM
authors.lastname: Lee
authors.affiliation: Industry-University Cooperation Foundation, Kyung Sung University, Busan, South Korea.
authors.forename: Dong-Seop
authors.initials: DS
authors.lastname: Chung
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000401:mortality; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D011379:Prognosis; D012016:Reference Values; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D047368:Tumor Burden; D055815:Young Adult
chemical_list: D019788:Fluorodeoxyglucose F18
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