Preoperative PET/CT 18F-FDG Standardized Uptake by Lymph Nodes as a Significant Prognostic Factor in Patients with Colorectal Cancer

We evaluated the prognostic value of preoperative 18F-FDG uptake by suspected lymph nodes (LNs) using 18F-FDG PET/CT in colorectal cancer patients. Methods. Patients with CRC underwent 18F-FDG PET/CT before radical surgery. We used Cox proportional hazards regression to examine the relationship between recurrence and the 18F-FDG maximum standardized uptake value (SUVmax) in the suspected LNs (SUVLN) on 18F-FDG PET/CT. Results. Clinical data, treatment modalities, and results from 90 CR C patients were reviewed. The median follow-up was 19 months (range 3 to 72 months). Receiver operating characteristic analysis identified SUVLN 1.15 was the optimal cut-off value for predicting recurrence. SUVLN correlated with tumour size (P = 0.045), lymph node metastasis (P = 0.03), and recurrence (P < 0.0001). Univariate analysis showed significant associations between recurrence and SUVLN (P = 0.017), and tumour grade (P = 0.013). Multivariate analysis identi›ed SUVLN (P < 0.0001), and tumour grade (P = 0.005) as independent risk factors for recurrence. Patients with SUVLN ≤ 1.15 and SUVLN > 0.15 difiered significantly in terms of recurrence (P < 0.0001). Conclusion. Preoperative SUVLN measured by 18F-FDG PET/CTwas significantly associated with recurrence and had significant prognostic value for recurrence-free survival in patients with colorectal cancer.