Preoperatively Treated Diffuse-Type Gastric Adenocarcinoma: Glucose vs. Other Energy Sources Substantially Influence Prognosis and Therapy Response

Autor: Catherine E Devine, Brian D. Badgwell, Yang Lu, Allison Trail, Jane E. Rogers, Prajnan Das, Rebecca E Waters, Madhavi Patnana, Ahmed Abdelhakeem, Xuemei Wang, Jaffer A. Ajani, Naruhiko Ikoma, Jeannelyn S. Estrella, Mariela A. Blum Murphy
Rok vydání: 2021
Předmět:
Zdroj: Cancers, Vol 13, Iss 420, p 420 (2021)
Cancers
Volume 13
Issue 3
ISSN: 2072-6694
Popis: Diffuse type of gastric adenocarcinoma (dGAC) generally confers a poor prognosis compared to intestinal type. Some dGACs are not avid on fluorine-18 fluoro-2-deoxy-D-glucose PET (FDG-PET) while others seem to consume glucose avidly. We analyzed the outcomes based on the avidity (high with standardized uptake value (SUV) >
3.5 or low with SUV &le
3.5) of the primary on baseline FDG-PET. We retrospectively selected 111 localized dGAC patients who had baseline FDG-PET (all were treated with preoperative chemotherapy and chemoradiation). FDG-PET avidity was compared with overall survival (OS) and response to therapy. The mean age was 59.4 years and with many females (47.7%). The high-SUV group (58 (52.3%) patients) and the low-SUV group (53 (47.7%) patients) were equally divided. While the median OS for all patients was 49.5 months (95% CI: 38.5&ndash
98.8 months), it was 98.0 months (95% CI: 49.5&ndash
NE months) for the low-SUV group and 36.0 months for the high-SUV (p = 0.003). While the median DFS for all patients was 38.2 months (95% CI: 27.7&ndash
97.6 months), it was 98.0 (95% CI: 36.9&ndash
NE months) months for the low-SUV group was and only 27.0 months (95% CI: 15.2&ndash
63.2 months) for the high-SUV group (p = 0.005). Clinical responses before surgery were more common in the low-SUV group but overall we observed only 4 pathologic complete responses in 111 patients. Our unique data suggest that if dGACs used glucose as an energy source then the prognosis was very poor while non-glucose sources improved prognosis. Multi-platform (including metabolomics) profiling of dGACs would yield useful biologic understanding.
Databáze: OpenAIRE
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