Total metabolic tumor volume and spleen metabolism on baseline [18F]-FDG PET/CT as independent prognostic biomarkers of recurrence in resected breast cancer

Romain-David Seban (1) , Roman Rouzier (2) , Aurelien Latouche (3, 4) , Nicolas Deleval (2) , Jean-Marc Guinebretiere (2) , Irene Buvat (1) , Francois-Clement Bidard (2) , Laurence Champion (1)

1 LITO - Laboratoire d'Imagerie Translationnelle en Oncologie
2 Institut Curie [Paris]
3 Cancer et génome: Bioinformatique, biostatistiques et épidémiologie d'un système complexe
4 CNAM - Conservatoire National des Arts et Métiers [CNAM]

Purpose We evaluated whether biomarkers on baseline [ 18 F]-FDG PET/CT are associated with recurrence after surgery in patients with invasive breast cancer of no special type (NST). Methods In this retrospective single-center study, we included consecutive patients with non-metastatic breast cancer of NST who underwent [ 18 F]-FDG PET/CT before treatment, including surgery, between 2011 and 2016. Clinicopathological data were collected. Tumor SUVmax, total metabolic tumor volume (TMTV), and spleen-and bone marrow-to-liver SUVmax ratios (SLR, BLR) were measured from the PET images. Cutoff values were determined using predictiveness curves to predict 5-year recurrence-free survival (5y-RFS). A multivariable prediction model was developed using Cox regression. The association with stromal tumor-infiltrating lymphocytes (TILs) levels (low if <50%) was studied by logistic regression. Results Three hundred and three women were eligible, including 93 (31%) with triple-negative breast carcinoma. After a median follow-up of 6.2 years, 56 and 35 patients experienced recurrence and death, respectively. The 5y-RFS rate was 86%. In multivariable analyses, high TMTV (>20 cm3) and high SLR (>0.76) were associated with shorter 5y-RFS (HR 2.4, 95%CI 1.3-4.5, and HR 1.9, 95%CI 1.0-3.6). In logistic regression, high SLR was the only independent factor associated with low stromal TILs (OR 2.8, 95%CI 1.4-5.7). Conclusion High total metabolic tumor volume and high spleen glucose metabolism on baseline [ 18 F]-FDG PET/CT were associated with poor 5y-RFS after surgical resection in patients with breast cancer of NST. Spleen metabolism was inversely correlated with stromal TILs and might be a surrogate for an immunosuppressive tumor microenvironment. Keywords Invasive breast cancer of no special type. [18F]-FDG PET/CT. Prognosis. Total metabolic tumor volume. Spleen glucose metabolism. Stromal tumor-infiltrating lymphocytes This article is part of the Topical Collection on Oncology-General

Mots clés: Invasive breast cancer of no special type; Prognosis; Total metabolic tumor volume; Spleen glucose metabolism; Stromal tumor-infiltrating lymphocytes; [18F]-FDG PET/CT

Domaines: Cancer; Imagerie

Romain-David Seban, Roman Rouzier, Aurelien Latouche, Nicolas Deleval, Jean-Marc Guinebretiere, et al.. Total metabolic tumor volume and spleen metabolism on baseline [18F]-FDG PET/CT as independent prognostic biomarkers of recurrence in resected breast cancer. European Journal of Nuclear Medicine and Molecular Imaging, 2021, 48 (11), pp.3560-3570. ⟨10.1007/s00259-021-05322-2⟩. ⟨hal-03441739⟩