alexa The Impact of Pretreatment 18F-FDG (PET/CT) Maximum Sta
ISSN: 2155-9619

Journal of Nuclear Medicine & Radiation Therapy
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Research Article

The Impact of Pretreatment 18F-FDG (PET/CT) Maximum Standardized Uptake Value and Neutrophil/Lymphocyte Ratio (NLR) in Predicting Prognosis in Surgically Treated Oligometastatic Breast Cancer Patients

Hala A El-Lathy1,2*, Ahlam A Dohal1 and Ahmed E Abbas3,4

1Departments of Radiation Oncology, King Fahad Specialist Hospital, Dammam, Saudi Arabia

2Departments of Clinical Oncology, Alexandria University, Egypt

3Departments of Surgical Oncology, King Fahad Specialist Hospital, Dammam, Saudi Arabia

4Department of Surgical Oncology, National Cancer Institute, Cairo University, Egypt

*Corresponding Author:
Hala A El-Lathy, MD
Radiation Oncology Departments at
King Fahad Specialist Hospital
Dammam, Saudi Arabia
Tel: +966540367076
Fax: +96638412684
E-mail: [email protected]

Received date: November 21, 2015 Accepted date: December 09, 2015 Published date: December 15, 2015

Citation: El-Lathy HA, Dohal AA, Abbas AE (2015) The Impact of Pretreatment 18F-FDG (PET/CT) Maximum Standardized Uptake Value and Neutrophil/Lymphocyte Ratio (NLR) in Predicting Prognosis in Surgically Treated Oligometastatic Breast Cancer Patients. J Nucl Med Radiat Ther 7:271. doi:10.4172/2155-9619.1000271

Copyright: © 2015 El-Lathy HA, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License; which permits unrestricted use; distribution; and reproduction in any medium; provided the original author and source are credited.



Purpose: To evaluate baseline PET/CT SUVmax value and Neutrophil/lymphocyte ratio (NLR), as prognostic indicators of progression free survival (PFS) and overall survival (OS) in surgically treated oligmetastatic breast cancer (OMBC) patients.

Materials and Methods: The pretreatment 18FDG-PET-CT SUVmax and NLR in surgically treated OMBC patients were compared with clinicopathological parameters. The prognostic value of pretreatment SUVmax and NLR for PFS and OS were assessed using Log rank and Cox regression.

Results: Overall, 87 OMBC were included, mastectomy and axillary clearance was performed in 72 patients (83%) who responded to preoperative systemic. The receiver operator curve (ROC) demonstrated that SUVmax of 4.4 and 6.5 to be the cut off value for predicting PFS in patients with oligometastasis to bones and visceral organs respectively. Additionally, baseline NLR cut off value of 2.7 predicted PFS in all studied patients. In surgically treated 46 OMBC patients (64%) to bones SUVmax of >4.4 had a significantly shorter OS [Hazard ratio (HR 2.9)] <4.4 (P<0.01), whereas patients with SUVmax of ≤4.4 had significantly longer PFS compared with those with SUVmax >4.4 (P=0.02). Similarly, 26 OMBC patients (36%) to visceral organs with SUVmax ≤6.5 had significant improvement in OS compared to those with SUVmax >6.5 (HR 2.3)]. Moreover, patients with NLR ≥2.7 showed significantly lower PFS (HR, 2., P<0.001) and overall survival rate (HR,1.9, P=0.02) than patients with NLR<2.7. Cox regression multivariate for OS revealed that higher baseline SUV max and NLR along with visceral metastasis were independently correlated with poor prognosis, with HR 3.04, 8.83 and 9.21 respectively. Conclusion: The pretreatment PET-CT SUVmax and NLR showed


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