Body Mass Index with Tumor F-18-FDG Uptake Improves Risk Stratification in Patients with Breast Cancer
- Authors
- Hyun, Seung Hyup; Ahn, Hee Kyung; Lee, Joo Hee; Choi, Joon Young; Kim, Byung-Tae; Park, Yeon Hee; Im, Young-Hyuck; Lee, Jeong Eon; Nam, Seok Jin; Lee, Kyung-Han
- Issue Date
- 31-Oct-2016
- Publisher
- PUBLIC LIBRARY SCIENCE
- Citation
- PLOS ONE, v.11, no.10
- Journal Title
- PLOS ONE
- Volume
- 11
- Number
- 10
- URI
- https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/7778
- DOI
- 10.1371/journal.pone.0165814
- ISSN
- 1932-6203
- Abstract
- Purpose To investigate the combined prognostic impact of body mass index (BMI) and tumor standardized uptake value (SUV) measured on pretreatment 18 F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) in patients with breast cancer. Methods We evaluated a cohort of 332 patients with newly diagnosed breast cancer (stage I-III) who underwent pretreatment FDG PET/CT followed by curative resection. Patients were categorized as overweight (BMI >= 23 kg/m(2)) or normal weight (BMI < 23 kg/m(2)). Primary tumor maximum SUV was measured by FDG PET/CT. Associations between BMI and tumor SUV with disease recurrence were assessed using Cox regression models. Results Median follow-up was 39 months. There were 76 recurrences and 15 cancer-related deaths. Multivariable Cox regression analysis demonstrated that high tumor SUV (hazard ratio [HR] = 1.75; 95% CI, 1.02-3.02; P = 0.044) and overweight (HR = 1.84; 95% CI, 1.17-2.89; P = 0.008) were independent poor prognostic factors. Positive hormone receptor status was an independent predictor of favorable outcome (HR = 0.42; 95% CI, 0.26-0.68; P < 0.001). Overweight patients with high tumor SUV had a two-fold risk of recurrence compared to patients with normal weight or low tumor SUV after adjusting for clinical stage and tumor subtype (HR = 2.06; 95% CI, 1.30-3.27; P = 0.002). Conclusions In patients with breast cancer, higher tumor SUV was associated with a more adverse outcome particularly in overweight women. BMI status combined with tumor SUV data allows better risk-stratification of breast cancer, independent of clinical stage and tumor subtype.
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