ECE2017 Oral Communications Cardiovascular endocrinology (1) (5 abstracts)
High Total 68Ga-DOTATATE-Avid Tumor Volume (TV) is associated with low progression-free survival and high disease-specific mortality rate in patients with neuroendocrine tumors
Amit Tirosh 1, , Georgios Z. Papadakis 1, , Corina Millo 1 , Samira M. Sadowski 4 , Peter Herscovitch 1 , Karel Pacak 1 , Stephen J. Marx 1 , Lily Yang 5 , Pavel Nockel 5 , Jasmine Shell 5 , Patience Green 5 , Xavier M. Keutgen 6 , Dhaval Patel 5 , Naris Nilubol 5 & Electron Kebebew 5
1National Institutes of Health, Bethesda, MD, USA; 2Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; 3Institute of Computer Science (ICS), Foundation for Research and Technology Hellas (FORTH), Crete, Greece; 4Endocrine and Thoracic Surgery, University Hospitals of Geneva, Geneva, Switzerland; 5Endocrine Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA; 6Department of Surgery, Rush University Medical Center, Chicago, IL, USA.
Background: Patients with neuroendocrine tumors (NETs) have divergent survival, even when having the same site of primary tumor, and tumor stage and grade. 68Gallium (68Ga)-DOTATATE positron emission tomography (PET)/computed tomography (CT) is a sensitive imaging modality for detecting NETs. The purpose of this study was to determine whether 68Ga-DOTATATE PET/CT imaging has any prognostic utility in patients with NETs.
Methods: One hundred and eighty-four patients with NETs were enrolled in a prospective study of 68Ga-DOTATATE PET/CT imaging and comprehensive biochemical analysis. Total 68Ga-DOTATATE-Avid Tumor Volume (68Ga-DOTATATE TV) was measured in all participants. The primary outcome measures were progression-free survival (PFS) and disease-specific mortality (DSM). PFS and DSM rates were compared according to 68Ga-DOTATATE TV quartiles of the current cohort. Then, specific 68Ga-DOTATATE TV cut-offs were set using a receiver operating characteristic (ROC) curve analysis, and the risks for DSM and PFS were validated with Kaplan-Meyer and Cox regression analyses.
Results: Patients were followed for a median of 18 months (range 4–35 months). 68Ga-DOTATATE TV quartiles had inverse correlation with PFS (P=0.001) and survival rates (P=0.002). Using cut-offs derived from ROC curve analysis, 68Ga-DOTATATE TV ≥7.0 was associated with a lower PFS (HR=2.0, P=0.03), and 68Ga-DOTATATE TV ≥35.8 ml was associated with increased (HR=10.7) disease-specific mortality in multivariate analysis (P=0.03), as well as in subgroup analysis of patients with pancreatic NETs.
Conclusions: We show for the first time the prognostic utility of 68Ga-DOTATATE TV in a large cohort of patients with NETs, enabling clinicians to determine the need for intervention using this non-invasive tool.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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