Annals of Medicine (Dec 2024)

Prognostic value of [18F]FDG PET/CT in metastatic hormone-sensitive prostate cancer at initial diagnosis: a retrospective cohort study

  • Ang Li,
  • Kai Shen,
  • Yiyi Ji,
  • Weiwei Zhang,
  • Bo Liu,
  • Ruopeng Su,
  • Xiang Zhou,
  • Liang Dong,
  • Yinjie Zhu,
  • Baijun Dong,
  • Jiahua Pan,
  • Qi Wang,
  • Wei Xue

DOI
https://doi.org/10.1080/07853890.2024.2411017
Journal volume & issue
Vol. 56, no. 1

Abstract

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Introduction This retrospective study aimed to evaluate the prognostic value of [18F]FDG parameters in patients with visceral and bone metastatic hormone-sensitive prostate cancer (mHSPC).Patients and methods This analysis included the mHSPC patients who underwent [18F]FDG PET/CT at the initial diagnosis. Baseline characteristics were analyzed, and the uptake of [18F]FDG was quantified using SUVmax. Kaplan–Meier and Cox proportional hazard regression analysis were employed to evaluate the correlation between SUVmax and patient survival.Results Among the 267 patients enrolled, 90 (33.7%) presented with visceral metastases and 177 (66.3%) had bone metastases. The median follow-up for the visceral metastasis group was 35.5 months (IQR 26–53.8 months). The median overall survival for patients with lung, liver, or both metastases were 30, 21 and 17 months, respectively. Patients exhibiting higher [18F]FDG uptake in metastatic lesions experienced shorter overall survival (OS) in comparison to those with lower [18F]FDG uptake, both in the visceral metastases group (17 vs. 31 months, p = 0.002) and the bone metastases group (27.5 vs. 34.5 months, p < 0.001). Cox regression analysis further revealed that increased [18F]FDG uptake in metastatic lesions emerged as a significant risk factor in both OS and progression-free survival (PFS). In contrast, the variability in [18F]FDG uptake in primary lesions did not provide a reliable indicator for predicting prognosis.Conclusions In mHSPC patients, higher [18F]FDG uptake in metastatic lesions indicates shorter survival and increased risk of disease progression. The [18F]FDG SUVmax in primary tumors did not show significant prognostic value. Our study underscores the unique prognostic potential of [18F]FDG PET/CT in mHSPC patients, highlighting its importance in the management of both bone and visceral metastases.

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