Metabolic tumour volume of anal carcinoma on (18)FDG PET/CT before combined radiochemotherapy is the only independant determinant of recurrence free survival

Siamak Mohammadkhani Shali, Vanessa Schmitt, Florian F. Behrendt, Oliver H. Winz, Alexander Heinzel, Felix M. Mottaghy, Michael J. Eble, Frederik A. Verburg*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Aim: to determine whether [F-18]2-fluoro-2-deoxyglucose (FDG) positron emission tomography and X-ray computed tomography (PET/CT) findings and metabolic parameters before combined chemo- and radiotherapy (CRT) have a prognostic value in patients with anal carcinoma.Materials and methods: 45 patients with anal cancer who underwent pre-treatment FDG-PET/CT were included. Metabolic parameters, recurrence and anal carcinoma specific survival were analyzed.Results: Shy max and metabolic volume of the primary tumour were significantly higher in patients with lymph node or distant metastases than in those with locally confined disease (p = 0.020 and p = 0.015, respectively). The extent of disease (local tumour only, lymph node or distant metastases) was highly predictive of both for recurrence free and disease specific survival (p = 0.010 and p < 0.001, respectively). Recurrence free (p = 0.010) and anal carcinoma specific survival (p = 0.006) differed significantly between patients with a metabolic volume <45 ml and >45 ml. Multivariate analysis revealed that a metabolic volume >45 ml was the only significant independent determinant (p = 0.19) for recurrence free survival whereas for anal carcinoma specific survival the extent of disease was identified as the only significant independent determinant (p = 0.002).Conclusions: the extent of disease on FDG PET/CT before combined radio-chemotherapy is strongly predictive of prognosis in anal cancer. Furthermore, patients with a large metabolic volume of the primary tumour (>45 ml) are at significantly higher risk of recurrence. (C) 2016 Elsevier Ireland Ltd. All rights reserved.
Original languageEnglish
Pages (from-to)1390-1394
JournalEuropean Journal of Radiology
Issue number8
Publication statusPublished - Aug 2016


  • Anal carcinoma
  • Rad iochemotherapy
  • Radiation therapy planning
  • Prognosis

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