title: Predictive Role of the Number of 18F-FDG-Positive Lymph Nodes Detected by PET/CT for Pre-Treatment Evaluation of Locally Advanced Gastric Cancer.
abstract: OBJECTIVE
  The aim of this study was to investigate the predictive value of the numbers of metabolically positive lymph nodes (MPLN) detected by 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/computed tomography (CT) in patients with locally advanced gastric cancer (LAGC).
  
  
  METHODS
  We retrospectively analyzed the records of 50 patients with LAGC (stage T2-T4) who had undergone pre-operative PET/CT examination and laparotomy (total gastrectomy, n = 11; subtotal gastrectomy, n = 13; distal gastrectomy, n = 22; and bypass with gastrojejunstomy, n = 4). The numbers of MPLN were determined by combining visual observations with semi-quantitative measurements of the maximized standardized uptake value (SUVmax). Performance was investigated in terms of predicting post-surgical overall survival (OS).
  
  
  RESULTS
  The median post-surgical OS was 32.57 months (range 3.0-94 months). The numbers of MPLN were moderately correlated with the numbers of histological positive LN (r = 0.694, p = 0.001). In univariate analyses, the numbers of MPLN (≤ 2 vs. ≥3), PET/CT LN (positivity vs. negativity), SUVmax of LN (< 2.8 vs. ≥ 2.8), TNM stage (I, II vs. III, IV), and surgery type (R0 vs. non-R0) were significantly associated with OS. In multivariate analysis, surgery type (R0 vs. non-R0) and numbers of MPLN (≤ 2 vs. ≥ 3) were both independent factors for poor OS.
  
  
  CONCLUSIONS
  This explored study indicates that the number of MPLN could provide additional information for LAGC prognosis. Patients with MPLNs ≥ 3 may be at the risk of the more bad outcomes, and the further clinical trials are needed.
authors.affiliation: PET/CT-MRI Centre, Harbin Medical University Cancer Hospital, Nangang District, Harbin, Heilongjiang Province, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Gastroenterological Surgery, Harbin Medical University Cancer Hospital, Nangang District, Harbin, Heilongjiang Province, China.
authors.forename: Yuzhe
authors.initials: Y
authors.lastname: Wei
authors.affiliation: Department of Gastroenterological Surgery, Harbin Medical University Cancer Hospital, Nangang District, Harbin, Heilongjiang Province, China.
authors.forename: Yingwei
authors.initials: Y
authors.lastname: Xue
authors.affiliation: PET/CT-MRI Centre, Harbin Medical University Cancer Hospital, Nangang District, Harbin, Heilongjiang Province, China.
authors.forename: Peiou
authors.initials: P
authors.lastname: Lu
authors.affiliation: PET/CT-MRI Centre, Harbin Medical University Cancer Hospital, Nangang District, Harbin, Heilongjiang Province, China.
authors.forename: Lijuan
authors.initials: L
authors.lastname: Yu
authors.affiliation: Department of Radiology, Fourth Hospital of Harbin Medical University, Nangang District, Harbin, Heilongjiang Province, China.
authors.forename: Baozhong
authors.initials: B
authors.lastname: Shen
mesh_terms: D000368:Aged; D005260:Female; D019788:Fluorodeoxyglucose F18; D005743:Gastrectomy / Q000379:methods; D015390:Gastric Bypass / Q000379:methods; D006801:Humans; D053208:Kaplan-Meier Estimate; D008198:Lymph Nodes / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D017063:Outcome Assessment, Health Care / Q000379:methods / Q000706:statistics & numerical data; D000072078:Positron Emission Tomography Computed Tomography / Q000379:methods*; D057234:Preoperative Period; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods / Q000706:statistics & numerical data; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery
chemical_list: D019788:Fluorodeoxyglucose F18