title: Anal cancer FDG-PET standard uptake value: correlation with tumor characteristics, treatment response and survival.
abstract: OBJECTIVE
  The present work studies the correlation of (18) F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) standardized uptake value (SUV) with tumor characteristics, clinical response and prognosis in a series of anal canal cancer patients treated with chemo-radiotherapy.
  
  
  METHODS
  Fifty-five patients were included in the present analysis. PET maximum SUV (SUVmax) of primary tumor was calculated for each patient. The correlation with clinical parameters, tumor response and survival data were analyzed.
  
  
  RESULTS
  SUVmax significantly correlated with T-stage (p = 0.01) and histology (p = 0.03). Median SUVmax was higher for lesions with partial response (PR, 21/55, 38%) than for lesions with complete response (CR, 34/55, 62%) but without statistical significance (p = 0.17). The actuarial disease-free survival (DFS) and overall survival (OS) rates were 53.0 and 77.8% at 2 years and 41.3 and 58.6% at 5 years, respectively. Median SUVmax did not statistically correlate with clinical response or survival. CR and T1-T2 stage were statistically significant prognostic factors for disease-free survival (p < 0.0001 and p = 0.02, respectively) and CR was significant also for overall survival (p < 0.0001).
  
  
  CONCLUSIONS
  Our data suggest that pre-treatment FDG-PET/CT SUVmax cannot directly predict tumor response and survival, but it is strongly associated with tumor characteristics such as primary tumor stage and histology, being the first one of the most important and validated prognostic factors for anal cancer.
authors.affiliation: Radiotherapy, University Hospital "Maggiore della Carità", Novara, Italy.|Department of Translational Medicine, University of "Piemonte Orientale", Via Solaroli, 17, 28100, Novara, Italy.
authors.forename: Letizia
authors.initials: L
authors.lastname: Deantonio
authors.affiliation: Radiotherapy, University Hospital "Maggiore della Carità", Novara, Italy.
authors.forename: Maria Elisa
authors.initials: ME
authors.lastname: Milia
authors.affiliation: Biostatistics and Clinical Epidemiology, University Hospital "Maggiore della Carità", Novara, Italy.|Department of Translational Medicine, University of "Piemonte Orientale", Via Solaroli, 17, 28100, Novara, Italy.
authors.forename: Tiziana
authors.initials: T
authors.lastname: Cena
authors.affiliation: Nuclear Medicine, University Hospital "Maggiore della Carità", Novara, Italy.
authors.forename: Gianmauro
authors.initials: G
authors.lastname: Sacchetti
authors.affiliation: Radiotherapy, University Hospital "Maggiore della Carità", Novara, Italy.
authors.forename: Carola
authors.initials: C
authors.lastname: Perotti
authors.affiliation: Medical Physics, University Hospital "Maggiore della Carità", Novara, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Brambilla
authors.affiliation: Radiotherapy, University Hospital "Maggiore della Carità", Novara, Italy.
authors.forename: Lucia
authors.initials: L
authors.lastname: Turri
authors.affiliation: Radiotherapy, University Hospital "Maggiore della Carità", Novara, Italy. marco.krengli@med.unipmn.it.|Department of Translational Medicine, University of "Piemonte Orientale", Via Solaroli, 17, 28100, Novara, Italy. marco.krengli@med.unipmn.it.
authors.forename: Marco
authors.initials: M
authors.lastname: Krengli
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001005:Anus Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy; D001706:Biopsy; D059248:Chemoradiotherapy; D003287:Contrast Media; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods*; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D011379:Prognosis; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D015996:Survival Rate; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: (18) F-fluorodeoxyglucose; Anal cancer; Positron emission tomography; Prognosis; Standardized uptake value