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[18F]Fluorodeoxyglucose-positron emission tomography/computed tomography response evaluation can predict histological response at surgery after induction chemotherapy for oligometastatic bladder cancer

Johansson Kollberg, Petter LU ; Almquist, Helen; Bläckberg, Mats; Cwikiel, Magdalena LU ; Gudjonsson, Sigurdur LU ; Lyttkens, Kerstin LU ; Patschan, Oliver LU and Liedberg, Fredrik LU (2017) In Scandinavian Journal of Urology2013-01-01+01:00 51(4). p.308-313
Abstract

Objective: Patients with limited metastatic and locally advanced bladder cancer have a poor prognosis, and no definite treatment recommendations exist. However, long-term survival is possible for selected patients if surgery is combined with multiple courses of chemotherapy (i.e. induction chemotherapy). Patients with tumours that are insensitive to chemotherapy probably have little to gain from subsequent extensive surgery. The aim of this study was to evaluate sequential FDG-PET/CT examinations as an indicator of chemotherapy response. Materials and methods: Between 2007 and 2015, 50 patients with oligometastatic invasive bladder cancer selected for induction chemotherapy underwent two FDG-PET/CT examinations: the first before the... (More)

Objective: Patients with limited metastatic and locally advanced bladder cancer have a poor prognosis, and no definite treatment recommendations exist. However, long-term survival is possible for selected patients if surgery is combined with multiple courses of chemotherapy (i.e. induction chemotherapy). Patients with tumours that are insensitive to chemotherapy probably have little to gain from subsequent extensive surgery. The aim of this study was to evaluate sequential FDG-PET/CT examinations as an indicator of chemotherapy response. Materials and methods: Between 2007 and 2015, 50 patients with oligometastatic invasive bladder cancer selected for induction chemotherapy underwent two FDG-PET/CT examinations: the first before the start of chemotherapy and the second after three courses of cisplatinum-based combination chemotherapy. Responders were given up to six courses of chemotherapy. FDG-PET/CT response was correlated with histological response in excised lymph-node metastases. Results: Three patients showed progression to incurable disease during chemotherapy and another two patients did not undergo surgery, for medical reasons. Lymphadenectomy was performed in the remaining 45 patients, of whom 43 had lymph-node metastasis. FDG-PET/CT prediction of the histological nodal chemotherapy response was correct in 37 (86%) of those 43. The second FDG-PET/CT examination identified four out of nine non-responders. For response, the sensitivity, specificity, and positive and negative predictive values for FDG-PET/CT accuracy were 37 out of 37 (100%), one out of six (17%), 37 out of 42 (88%) and one out of one (100%), respectively. Conclusions: Repeated FDG-PET/CT seems to predict histological response. However, with the histological response criteria used in this study, five non-responders were not identified by the second FDG-PET/CT investigation.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Chemotherapy, computed tomography, FDG-PET/CT, induction chemotherapy, treatment response, urothelial carcinoma
in
Scandinavian Journal of Urology2013-01-01+01:00
volume
51
issue
4
pages
6 pages
publisher
Taylor & Francis
external identifiers
  • scopus:85019627939
  • wos:000405483400013
ISSN
2168-1805
DOI
10.1080/21681805.2017.1321579
language
English
LU publication?
yes
id
1a0acbe6-5ed2-4e6d-be47-98ec15ceabbd
date added to LUP
2017-06-30 14:45:20
date last changed
2018-01-07 12:10:08
@article{1a0acbe6-5ed2-4e6d-be47-98ec15ceabbd,
  abstract     = {<p>Objective: Patients with limited metastatic and locally advanced bladder cancer have a poor prognosis, and no definite treatment recommendations exist. However, long-term survival is possible for selected patients if surgery is combined with multiple courses of chemotherapy (i.e. induction chemotherapy). Patients with tumours that are insensitive to chemotherapy probably have little to gain from subsequent extensive surgery. The aim of this study was to evaluate sequential FDG-PET/CT examinations as an indicator of chemotherapy response. Materials and methods: Between 2007 and 2015, 50 patients with oligometastatic invasive bladder cancer selected for induction chemotherapy underwent two FDG-PET/CT examinations: the first before the start of chemotherapy and the second after three courses of cisplatinum-based combination chemotherapy. Responders were given up to six courses of chemotherapy. FDG-PET/CT response was correlated with histological response in excised lymph-node metastases. Results: Three patients showed progression to incurable disease during chemotherapy and another two patients did not undergo surgery, for medical reasons. Lymphadenectomy was performed in the remaining 45 patients, of whom 43 had lymph-node metastasis. FDG-PET/CT prediction of the histological nodal chemotherapy response was correct in 37 (86%) of those 43. The second FDG-PET/CT examination identified four out of nine non-responders. For response, the sensitivity, specificity, and positive and negative predictive values for FDG-PET/CT accuracy were 37 out of 37 (100%), one out of six (17%), 37 out of 42 (88%) and one out of one (100%), respectively. Conclusions: Repeated FDG-PET/CT seems to predict histological response. However, with the histological response criteria used in this study, five non-responders were not identified by the second FDG-PET/CT investigation.</p>},
  author       = {Johansson Kollberg, Petter and Almquist, Helen and Bläckberg, Mats and Cwikiel, Magdalena and Gudjonsson, Sigurdur and Lyttkens, Kerstin and Patschan, Oliver and Liedberg, Fredrik},
  issn         = {2168-1805},
  keyword      = {Chemotherapy,computed tomography,FDG-PET/CT,induction chemotherapy,treatment response,urothelial carcinoma},
  language     = {eng},
  month        = {05},
  number       = {4},
  pages        = {308--313},
  publisher    = {Taylor & Francis},
  series       = {Scandinavian Journal of Urology2013-01-01+01:00},
  title        = {[<sup>18</sup>F]Fluorodeoxyglucose-positron emission tomography/computed tomography response evaluation can predict histological response at surgery after induction chemotherapy for oligometastatic bladder cancer},
  url          = {http://dx.doi.org/10.1080/21681805.2017.1321579},
  volume       = {51},
  year         = {2017},
}