title: Association between survival and maximum standardized uptake value of liver metastases detected by 18-fluoro-2-deoxy-D-glucose positron emission tomography-computed tomography in patients with adenocarcinoma of unknown primary origin.
abstract: OBJECTIVE
  The objective of this retrospective study is to investigate the association between survival and maximum standardized uptake values (SUVmax) of liver metastases detected by pre-treatment positron emission tomography-computed tomography (PET-CT) in patients with adenocarcinoma of unknown primary origin (ACUP).
  
  
  METHODS
  A total of 58 patients with ACUP and liver metastases confirmed histopathologically by liver biopsy and pre-treatment PET-CT were included in this study. SUVmax values of the liver lesions were measured and their association with survival was investigated.
  
  
  RESULTS
  The median age was 62 years; 63.8 % of the patients were males and 36.2 % were females. The median overall survival was calculated as 10.7 months (OS). The median SUVmax of the liver metastases was 8.6. Accordingly, two groups were established: one with values <8.6 and the other with ones ≥8.6. No differences were detected between the two groups with respect to general characteristics. Median OS was 13.2 months in the group with SUVmax <8.6 compared to 7.4 months in the group with SUVmax ≥8.6. This difference was statistically significant (p = 0.033). SUVmax (HR 1.104, 95 % CI 1.013-1.204, p = 0.025), age (HR 1.033, 95 % CI 1.002-1.064, p = 0.034), presence of chemotherapy (HR 2.296, 95 % CI 1.136-4.641, p = 0.021) and LDH level (HR 1.002, 95 % CI 1.001-1.003, p = 0.007) were identified as independent prognostic factors affecting survival in the multivariable analysis. This is the first report evaluating the impact of SUVmax for liver metastases on ACUP patient survival.
  
  
  CONCLUSIONS
  The SUVmax of liver metastases evaluated by PET-CT is a prognostic factor influencing survival of patients with ACUP.
authors.affiliation: Department of Medical Oncology, Ankara Numune Education and Research Hospital, Sihhiye, 06100, Ankara, Turkey, efnanalgin@gmail.com.
authors.forename: Efnan
authors.initials: E
authors.lastname: Algin
authors.forename: Ahmet
authors.initials: A
authors.lastname: Ozet
authors.forename: Ozge
authors.initials: O
authors.lastname: Gumusay
authors.forename: Bulent
authors.initials: B
authors.lastname: Cetin
authors.forename: Umit O
authors.initials: UO
authors.lastname: Akdemir
authors.forename: Mustafa
authors.initials: M
authors.lastname: Benekli
authors.forename: Ugur
authors.initials: U
authors.lastname: Coskun
authors.forename: Aytug
authors.initials: A
authors.lastname: Uner
authors.forename: Ozlem
authors.initials: O
authors.lastname: Kapucu
authors.forename: Suleyman
authors.initials: S
authors.lastname: Buyukberber
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000000981:diagnostic imaging*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics; D006801:Humans; D053208:Kaplan-Meier Estimate; D008099:Liver / Q000000981:diagnostic imaging; D008113:Liver Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000556:secondary; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D049268:Positron-Emission Tomography / Q000379:methods*; D011379:Prognosis; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18