Initial FDG-PET/CT predicts survival in adults Ewing sarcoma family of tumors

// Bastien Jamet 1 , Thomas Carlier 2, 3 , Loic Campion 2, 4 , Emmanuelle Bompas 4 , Sylvie Girault 5 , Fanny Borrely 6 , Ludovic Ferrer 7 , Maxime Rousseau 1 , Yann Venel 6 , Françoise Kraeber-Bodéré 1, 2, 3 and Caroline Rousseau 1, 2 1 Nuclear Medicine Unit, ICO Cancer Center Gauducheau, Saint Herblain, France 2 Nantes-Angers Cancer Research Center, INSERM U892, CNRS UMR 6299, University of Nantes, Nantes, France 3 Nuclear Medicine Unit, University Hospital, Nantes, France 4 Oncology Unit, ICO Cancer Center Gauducheau, Saint Herblain, France 5 Nuclear Medicine Unit, ICO Cancer Center Papin, Angers, France 6 Nuclear Medicine Unit, University Hospital Bretonneau, Tours, France 7 Physics Unit, ICO Cancer Center Gauducheau, Saint Herblain, France Correspondence to: Bastien Jamet, email: bastien.jamet@chu-nantes.fr Keywords: FDG-PET/CT, oncology, Ewing sarcoma family of tumors, survival analysis, prognosis Received: May 11, 2017 Accepted: June 27, 2017 Published: August 18, 2017 ABSTRACT Purpose: The aim of this retrospective study was to determine, at baseline, the prognostic value of different FDG-PET/CT quantitative parameters in a homogenous Ewing Sarcoma Family of Tumors (ESFT) adult population, compared with clinically relevant prognostic factors. Methods: Adult patients from 3 oncological centers, all with proved ESFT, were retrospectively included. Quantitative FDG-PET/CT parameters (SUV (maximum, peak and mean), metabolic tumor volume (MTV) and total lesion glycolysis (TLG) of the primary lesion of each patient were recorded before treatment, as well as usual clinical prognostic factors (stage of disease, location, tumor size, gender and age). Then, their relation with progression free survival (PFS) and overall survival (OS) was evaluated. Results: 32 patients were included. Median age was 21 years (range, 15 to 61). Nineteen patients (59%) were initially metastatic. On multivariate analysis, high SUV max remained independent predictor of worst OS (p=0.02) and PFS (p=0.019), metastatic disease of worst PFS (p=0.01) and high SUVpeak of worst OS (p=0.01). Optimal prognostic cut-off of SUV peak was found at 12.5 in multivariate analyses for PFS and OS ( p =0.0001). Conclusions: FDG-PET/CT, recommended at ESFT diagnosis for initial staging, can be a useful tool for predicting long-term adult patients outcome through semi-quantitative parameters.