title: Metabolic activity measured on PET/CT correlates with clinical outcomes in patients with limb and girdle sarcomas.
abstract: OBJECTIVE
  To explore the relationship between metabolic activity and outcome in patients with extremity sarcomas.
  
  
  METHODS
  Between June 2004 and December 2011, 120 patients with newly diagnosed limb and girdle sarcomas underwent FDG-PET/CT for disease staging prior to curative intent treatment. The maximum standardized uptake value (SUV(max)) was measured for each primary tumor and correlated with outcome. Progression-free survival and overall survival (OS) were analyzed using the Kaplan-Meier method.
  
  
  RESULTS
  Soft-tissue sarcomas were more frequent (68%) than bone (27%) or cartilage (5%) tumors. Median follow-up was 33.2 months. 51% of patients progressed during the follow-up interval and 38% died. SUV(max) was dichotomized with a cut-point of 10.3. Patients with SUV(max) < 10.3 had better DFS and OS compared with patients with SUV(max) ≥ 10.3 (P < 0.001 and P < 0.001, respectively [log-rank test]). Multivariate analysis confirmed that even after adjusting for age, sex, site, tumor type (bone vs. soft-tissue), grade, and stage; an SUV(max) ≥ 10.3 correlated with a twofold risk of progression and 2.4 times greater risk of death (hazard ratio [HR] 2.0, 95% CI, 1.1-3.7, and HR, 2.4, 95% CI, 1.1-4.9).
  
  
  CONCLUSIONS
  SUV(max) is an independent adverse prognostic factor for both progression and OS in patients with extremity sarcomas.
authors: Department of Radiation Oncology, McGill University Health Centre/Montreal General Hospital, Montreal, Quebec, Canada.
authors: Sonia R
authors: SR
authors: Skamene
authors: Rajan
authors: R
authors: Rakheja
authors: Kristina R
authors: KR
authors: Dahlstrom
authors: Kristina R
authors: KR
authors: Dalhstrom
authors: David
authors: D
authors: Roberge
authors: Ayoub
authors: A
authors: Nahal
authors: Mathieu
authors: M
authors: Charest
authors: Robert
authors: R
authors: Turcotte
authors: Marc
authors: M
authors: Hickeson
authors: Carolyn
authors: C
authors: Freeman
mesh_terms: D000328:Adult; D000368:Aged; D017024:Chemotherapy, Adjuvant; D018572:Disease-Free Survival; D005121:Extremities / Q000473:pathology; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000378:metabolism*; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography / Q000379:methods; D011237:Predictive Value of Tests; D011379:Prognosis; D019275:Radiopharmaceuticals / Q000378:metabolism; D018714:Radiotherapy, Adjuvant; D012509:Sarcoma / Q000175:diagnosis / Q000378:metabolism* / Q000473:pathology / Q000628:therapy*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: FDG-PET; SUVmax; prognosis; sarcoma