Prognostic Value of Restaging F-18 Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography to Predict 3-Year Post-Recurrence Survival in Patients with Recurrent Gastric Cancer after Curative Resection

OBJECTIVE: The aim of this study was to investigate the prognostic value of the maximum standardized uptake value (SUV(max)) measured while restaging with F-18 fluorodeoxyglucose ((18)F-FDG) positron emission tomography/computed tomography (PET/CT) to predict the 3-year post-recurrence survival (PRS) in patients with recurrent gastric cancer after curative surgical resection. MATERIALS AND METHODS: In total, 47 patients with recurrent gastric cancer after curative resection who underwent restaging with (18)F-FDG PET/CT were included. For the semiquantitative analysis, SUV(max) was measured over the visually discernable (18)F-FDG-avid recurrent lesions. Cox proportional-hazards regression models were used to predict the 3-year PRS. Differences in 3-year PRS were assessed with the Kaplan–Meier analysis. RESULTS: Thirty-nine of the 47 patients (83%) expired within 3 years after recurrence in the median follow-up period of 30.3 months. In the multivariate analysis, SUV(max) (p = 0.012), weight loss (p = 0.025), and neutrophil count (p = 0.006) were significant prognostic factors for 3-year PRS. The Kaplan–Meier curves demonstrated significantly poor 3-year PRS in patients with SUV(max) > 5.1 than in those with SUV(max) ≤ 5.1 (3-year PRS rate, 3.5% vs. 38.9%, p < 0.001). CONCLUSION: High SUV(max) on restaging with (18)F-FDG PET/CT is a poor prognostic factor for 3-year PRS. It may strengthen the role of (18)F-FDG PET/CT in further stratifying the prognosis of recurrent gastric cancer.