ArticleMolecular imaging and radionuclide therapy2026
Prognostic Value of Primary Tumor and Immune Organ Metabolic Parameters Derived from Pretreatment
Article in Molecular imaging and radionuclide therapy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: To investigate the association of primary tumor volume-based parameters and immune organ (liver, spleen, bone marrow) metabolic parameters and their derived ratios [spleen-to-liver ratio (SLR), bone marrow-to-liver ratio (BLR), spleen-to-bone marrow ratio (SBR)], measured on pretreatment Methods: 127 patients with histopathologically confirmed gastric adenocarcinoma who underwent pretreatment Results: There were 91 death events (71.7%); the Kaplan-Meier median overall survival was 16.56 months, with 1-, 3-, and 5-year survival rates of 58.3%, 33.1%, and 28.1%, respectively. No significant independent association with overall survival was demonstrated for any of the primary-tumor or immune-organ PET/CT parameters; the SBR was lower in deceased patients (p=0.041) and showed a non-significant protective trend at the univariate level [hazard ratio (HR)=0.802 per 1 standard deviation (SD); 95% confidence interval (CI) 0.621-1.038; p=0.093)], which was not supported by cut-off-based or multivariable analyses. In the primary multivariable model, distant metastasis independently increased the hazard of death (HR=1.798; 95% CI 1.187-2.723; p=0.006), whereas TLG SLR, and BLR showed no independent significance. In the stage-adjusted model, advanced stage remained independently associated with OS (HR=4.403; p=0.001). Conclusion: In this gastric adenocarcinoma cohort with a high proportion of advanced-stage disease, no independent association with overall survival was demonstrated for any of the evaluated tumor- or immune-organ PET/CT parameters; established clinicopathological factors showed stronger prognostic associations than the PET-derived parameters. The prognostic role of immune organ metabolism in gastric cancer should be evaluated in large prospective studies.
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