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Prognostic relevance of 18F-FDG uptake in patients with locally advanced soft tissue sarcoma of the extremities undergoing neoadjuvant treatment. 17 th CTOS Annual Meeting, Prague, Czech Republic, 2012. D. Andreou, H. Boldt, B. Jobke, M. Werner, D. Pink, M. Niethard, F. Traub, P.-U. Tunn.
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Prognostic relevance of 18F-FDG uptake in patients with locally advanced soft tissue sarcoma of the extremities undergoing neoadjuvant treatment 17th CTOS Annual Meeting, Prague, Czech Republic, 2012 D. Andreou, H. Boldt, B. Jobke, M. Werner, D. Pink, M. Niethard, F. Traub, P.-U. Tunn Department of Orthopedic Oncology Chair: P.-U. Tunn, MD Sarcoma Center Berlin-Brandenburg HELIOS Klinikum Berlin-Buch, Germany
Background Aim: To evaluate whether FDG-PET can accurately predict prognosis in patients with locally advanced soft tissue sarcoma undergoing ILP Department of Orthopedic Oncology, Sarcoma Center Berlin-Brandenburg, HELIOS Klinikum Berlin-Buch, Berlin, Germany
Patients and Methods • study design: prospective analysis • number of patients: 33 (17 men, 16 women) • time period: 2006 – 2009 • mean age: 57 years (range, 25 – 80) • mean follow-up: 28 months (range, 8 – 59) Department of Orthopedic Oncology, Sarcoma Center Berlin-Brandenburg, HELIOS Klinikum Berlin-Buch, Berlin, Germany
Patients and Methods • mean tumor size: 9.4 cm (range, 1.6 – 20.0) • tumor localization: lower extremity n = 26 upper extremity n = 7 • status at presentation: primary tumor n = 24 local recurrence n = 9 • statistics: t-test, Mann-Whitney U Kaplan-Meier, log-rank test Department of Orthopedic Oncology, Sarcoma Center Berlin-Brandenburg, HELIOS Klinikum Berlin-Buch, Berlin, Germany
Results p • mean SUVmax • prior to ILP9.3 (range, 1.5 – 35.5, median 6.3) • after ILP5.7 (range, 1.0 – 30.6, median 3.1) < 0.001 • mean SUVmaxprior to ILP • patients with metastases 11.2 (range, 3.6 – 35.5) • patients without metastases 8.6 (range, 1.5 – 27.1) 0.505 • mean SUVmaxafter ILP • patients with metastases 6.6 (range, 2.0 – 12.2) • patients without metastases 5.4 (range, 1.0 – 30.6) 0.109 Department of Orthopedic Oncology, Sarcoma Center Berlin-Brandenburg, HELIOS Klinikum Berlin-Buch, Berlin, Germany
Results – age and gender Metastasis-free survival Metastasis-free survival SUVmax2 ≤ median2 SUVmax1 ≤ median1 age ≤ 40 women SUVmax1 > median1 SUVmax2 > median2 men age > 40 Time in months Time in months p = 0.050 p = 0.530 Department of Orthopedic Oncology, Sarcoma Center Berlin-Brandenburg, HELIOS Klinikum Berlin-Buch, Berlin, Germany
Conclusions • it appears that the maximum SUV prior to treatment does not correlate with prognosis in patients with advanced localized high-grade soft tissue sarcomas of the extremities • a low SUVmax 6 weeks following ILP as a marker of good tumor response to the neoadjuvant treatment appears to be associated with an improved metastasis-free survival Department of Orthopedic Oncology, Sarcoma Center Berlin-Brandenburg, HELIOS Klinikum Berlin-Buch, Berlin, Germany
Conclusions • ongoing trial • 54 patients have currently been recruited • if these results are confirmed in a larger patient cohort, it would provide the rationale to evaluate whether patients with a high SUVmax following ILP might benefit from an adjuvant systemic chemotherapy Department of Orthopedic Oncology, Sarcoma Center Berlin-Brandenburg, HELIOS Klinikum Berlin-Buch, Berlin, Germany