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Total metabolic tumor volume and spleen metabolism on baseline [18F]-FDG PET/CT as independent prognostic biomarkers of recurrence in resected breast cancer
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Edité par CCSD ; Springer Verlag (Germany) [1976-....] -
International audience. Purpose We evaluated whether biomarkers on baseline [ 18 F]-FDG PET/CT are associated with recurrence after surgery in patients with invasive breast cancer of no special type (NST). Methods In this retrospective single-center study, we included consecutive patients with non-metastatic breast cancer of NST who underwent [ 18 F]-FDG PET/CT before treatment, including surgery, between 2011 and 2016. Clinicopathological data were collected. Tumor SUVmax, total metabolic tumor volume (TMTV), and spleen-and bone marrow-to-liver SUVmax ratios (SLR, BLR) were measured from the PET images. Cutoff values were determined using predictiveness curves to predict 5-year recurrence-free survival (5y-RFS). A multivariable prediction model was developed using Cox regression. The association with stromal tumor-infiltrating lymphocytes (TILs) levels (low if <50%) was studied by logistic regression. Results Three hundred and three women were eligible, including 93 (31%) with triple-negative breast carcinoma. After a median follow-up of 6.2 years, 56 and 35 patients experienced recurrence and death, respectively. The 5y-RFS rate was 86%. In multivariable analyses, high TMTV (>20 cm3) and high SLR (>0.76) were associated with shorter 5y-RFS (HR 2.4, 95%CI 1.3-4.5, and HR 1.9, 95%CI 1.0-3.6). In logistic regression, high SLR was the only independent factor associated with low stromal TILs (OR 2.8, 95%CI 1.4-5.7). Conclusion High total metabolic tumor volume and high spleen glucose metabolism on baseline [ 18 F]-FDG PET/CT were associated with poor 5y-RFS after surgical resection in patients with breast cancer of NST. Spleen metabolism was inversely correlated with stromal TILs and might be a surrogate for an immunosuppressive tumor microenvironment. Keywords Invasive breast cancer of no special type. [18F]-FDG PET/CT. Prognosis. Total metabolic tumor volume. Spleen glucose metabolism. Stromal tumor-infiltrating lymphocytes This article is part of the Topical Collection on Oncology-General
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