title: Prognostic impact of tumour burden assessed by metabolic tumour volume on FDG PET/CT in anal canal cancer.
abstract: OBJECTIVE
  The aim of this study was to confirm the prognostic value of metabolic tumour volume (MTV) at the primary site on initial work-up FDG PET/CT in patients with squamous cell carcinoma (SCC) of the anal canal.
  
  
  METHODS
  Patients with a recent diagnosis of SCC of the anal canal without metastases undergoing PET/CT for initial work-up and treated with (chemo)radiotherapy were retrospectively reviewed. Computer-aided MTV and SUVmax were determined. Survival rates were estimated using the Kaplan-Meier method. Cox regression analysis was used to evaluate prognostic variables of progression-free survival and overall survival (OS).
  
  
  RESULTS
  The study group comprised 75 patients who had an initial work-up PET/CT. Five patients (6.7 %) had stage I disease, 22 (29.3 %) stage II disease, 20 (26.7 %) stage IIIA disease, and 28 (37.3 %) stage IIIB disease. Median follow-up was 51 months (range 10 - 117 months). Global 4-year OS was 82.7 %, ranging from 100 % in patients with stage I disease to 75 % in patients with stage IIIB disease. MTV at the primary site was significantly and independently correlated with OS (p < 0.05), as patients with MTV less than 7 cm3had a better prognosis. SUVmax was not correlated with survival parameters. Metabolic involvement of the inguinal lymph nodes was also correlated with a poor outcome in the univariate analysis (p < 0.05).
  
  
  CONCLUSIONS
  MTV at the primary site is a prognostic biomarker in anal canal cancer. Hypermetabolic inguinal lymph nodes also appear to be correlated with survival.
authors: Médecine Nucléaire, Institut Curie, Saint-Cloud, France. mathieugauthe@yahoo.fr.|Médecine Nucléaire, Hôpital Tenon, 4 rue de la Chine, 75020, Paris, France. mathieugauthe@yahoo.fr.
authors: Mathieu
authors: M
authors: Gauthé
authors: Radiothérapie, Institut Curie, Saint-Cloud, France.
authors: Marion
authors: M
authors: Richard-Molard
authors: Oncologie Médicale, Institut Curie, Saint-Cloud, France.
authors: Juliette
authors: J
authors: Fayard
authors: Médecine Nucléaire, Institut Curie, Saint-Cloud, France.
authors: Jean-Louis
authors: JL
authors: Alberini
authors: Oncologie Médicale, Institut Curie, Saint-Cloud, France.
authors: Wulfran
authors: W
authors: Cacheux
authors: Oncologie Médicale, Institut Curie, Saint-Cloud, France.|Service des Maladies de l'Appareil Digestif, CHU Pontchaillou, Rennes, France.|Université Rennes 1, Rennes, France.
authors: Astrid
authors: A
authors: Lièvre
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001005:Anus Neoplasms / Q000000981:diagnostic imaging* / Q000401:mortality / Q000628:therapy*; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging* / Q000401:mortality / Q000628:therapy*; D059248:Chemoradiotherapy / Q000401:mortality*; D005260:Female; D019788:Fluorodeoxyglucose F18; D005602:France / Q000453:epidemiology; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D000072078:Positron Emission Tomography Computed Tomography; D015995:Prevalence; D011379:Prognosis; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012680:Sensitivity and Specificity; D015996:Survival Rate; D016896:Treatment Outcome; D047368:Tumor Burden / Q000187:drug effects / Q000528:radiation effects
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: Anal cancer; FDG; Initial work-up; Metabolic tumour volume; PET/CT