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Abstract
Glucose utilization by visceral adipose tissue (VAT) reflects inflammatory activity, which also promotes tumor growth and carcinogenesis. The effect of metabolically active VAT on survival outcomes in breast cancer is unknown. We investigated survival outcomes in patients with breast cancer based on the standardized uptake value (SUV) of VAT (SUVmean-VAT) using 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT). A total of 148 patients with breast cancer were divided into high- and low groups according to their SUVmean-VAT and SUVmax-tumor. Clinical characteristics and survival outcomes were compared between the groups. High SUVmean-VAT was associated with poor recurrence-free survival (RFS; hazard ratio [HR], 2.754; 95% confidence interval [CI], 1.090–6.958, p = 0.032) and distant metastasis-free survival (DMFS; HR, 3.500; 95% CI, 1.224–10.01, p = 0.019). Multivariate analysis showed that high SUVmean-VAT was a significant factor for poor RFS and poor DMFS (p = 0.023 and 0.039, respectively). High SUVmax-tumor was significantly associated with short RFS (p = 0.0388). Tumors with a high SUV tended to have a short DMFS, although the difference was not significant (p = 0.0718). Our findings showed that upregulated glucose metabolism in the VAT measured using 18F-FDG PET/CT may be a prognostic biomarker for adverse outcomes in breast cancer.
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1 Yonsei University College of Medicine, Department of Nuclear Medicine, Yongin Severance Hospital, Yongin, Republic of Korea (GRID:grid.15444.30) (ISNI:0000 0004 0470 5454)
2 Seoul St Mary’s Hospital, The Catholic University of Korea, Division of Breast Surgery, Department of Surgery, College of Medicine, Seoul, Republic of Korea (GRID:grid.414966.8) (ISNI:0000 0004 0647 5752)
3 Yonsei University College of Medicine, Department of Surgery, Gangnam Severance Hospital, Seoul, Republic of Korea (GRID:grid.15444.30) (ISNI:0000 0004 0470 5454); Yonsei University College of Medicine, Institute for Breast Cancer Precision Medicine, Seoul, Republic of Korea (GRID:grid.15444.30) (ISNI:0000 0004 0470 5454)
4 Yonsei University College of Medicine, Department of Nuclear Medicine, Gangnam Severance Hospital, Seoul, Republic of Korea (GRID:grid.15444.30) (ISNI:0000 0004 0470 5454)
5 Yonsei University College of Medicine, Institute for Breast Cancer Precision Medicine, Seoul, Republic of Korea (GRID:grid.15444.30) (ISNI:0000 0004 0470 5454); Yonsei University College of Medicine, Department of Pathology, Gangnam Severance Hospital, Seoul, Republic of Korea (GRID:grid.15444.30) (ISNI:0000 0004 0470 5454)