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Reappraisal of Prognostic Impact of Tumor SUVmax by 18F-FDG-PET/CT in Intrahepatic Cholangiocarcinoma

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Abstract

Background

We previously reported that tumor standardized uptake value (SUVmax) by 18F-fluorodeoxyglucose-positron emission tomography/computed tomography (PET/CT) was a potential predictor in patients undergoing surgery for intrahepatic cholangiocarcinoma (ICC). However, the prognostic value of SUVmax in the era of multidisciplinary strategy has remained unclear. The aim of this study was to reappraise the prognostic value of tumor SUVmax in patients undergoing surgery for ICC.

Methods

Data from 82 consecutive ICC patients, who underwent 18F-FDG-PET/CT and subsequent surgery between 2006 and 2017, were retrieved from a prospectively maintained institutional database. Adjuvant strategy was administrated during this study period in our center.

Results

Tumor SUVmax was associated with tumor size (p = 0.002) and tumor number (p = 0.005), but not associated with T and N stage classified by American Joint Committee on Cancer-classification system, and other tumor factors. According to the tumor SUVmax cut-off values of 8.0 based on the minimum p value approach, actuarial 5-year overall survival (OS) rates in patients undergoing upfront surgery for ICC were significantly stratified at 54.7% versus 26.0% (low vs. high tumor SUVmax group, p = 0.008). The actuarial 3-year disease-free survival (DFS) rates were also significantly stratified at 41.0% versus 18.3% (p < 0.001). Multivariate Cox regression analyses revealed that tumor SUVmax retained its significance on OS (p = 0.039) as well as DFS (p < 0.001).

Conclusion

Even in the era of multidisciplinary strategy, high tumor SUVmax still represents poor prognosis in patients undergoing surgery for ICC. These patients, therefore, would probably be required more effective strategies.

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References

  1. Kudo M, Izumi N, Ichida T et al (2016) Report of the 19th follow-up survey of primary liver cancer in Japan. Hepatol Res 46:372–390

    Article  PubMed  Google Scholar 

  2. Bridgewater J, Galle PR, Khan SA et al (2014) Guidelines for the diagnosis and management of intrahepatic cholangiocarcinoma. J Hepatol 60:1268–1289

    Article  PubMed  Google Scholar 

  3. Yoh T, Hatano E, Yamanaka K et al (2016) Is surgical resection justified for advanced intrahepatic cholangiocarcinoma? Liver Cancer 5:280–289

    Article  PubMed  PubMed Central  Google Scholar 

  4. Mavros MN, Economopoulos KP, Alexiou VG et al (2014) Treatment and prognosis for patients with intrahepatic cholangiocarcinoma: systematic review and meta-analysis. JAMA Surg 149:565–574

    Article  PubMed  Google Scholar 

  5. Yoh T, Hatano E, Nishio T et al (2016) Significant improvement in outcomes of patients with intrahepatic cholangiocarcinoma after surgery. World J Surg 40:2229–2236. https://doi.org/10.1007/s00268-016-3583-1

    Article  PubMed  Google Scholar 

  6. Seo S, Hatano E, Higashi T et al (2008) Fluorine-18 fluorodeoxyglucose positron emission tomography predicts lymph node metastasis, P-glycoprotein expression, and recurrence after resection in mass-forming intrahepatic cholangiocarcinoma. Surgery 143:769–777

    Article  PubMed  Google Scholar 

  7. Yoh T, Seo S, Ogiso S et al (2018) Proposal of a new preoperative prognostic model for solitary hepatocellular carcinoma incorporating 18F-FDG-PET imaging with the ALBI grade. Ann Surg Oncol 25:542–549

    Article  PubMed  Google Scholar 

  8. Kitamura K, Hatano E, Higashi T et al (2011) Prognostic value of (18)F-fluorodeoxyglucose positron emission tomography in patients with extrahepatic bile duct cancer. J Hepatobiliary Pancreat Sci 18:39–46

    Article  PubMed  Google Scholar 

  9. Yamashita S, Koay EJ, Passot G et al (2017) Local therapy reduces the risk of liver failure and improves survival in patients with intrahepatic cholangiocarcinoma: a comprehensive analysis of 362 consecutive patients. Cancer 123:1354–1362

    Article  CAS  PubMed  Google Scholar 

  10. Ercolani G, Vetrone G, Grazi GL et al (2010) Intrahepatic cholangiocarcinoma: primary liver resection and aggressive multimodal treatment of recurrence significantly prolong survival. Ann Surg 252:107–114

    Article  PubMed  Google Scholar 

  11. Sakamoto Y, Kokudo N, Matsuyama Y et al (2016) Proposal of a new staging system for intrahepatic cholangiocarcinoma: analysis of surgical patients from a nationwide survey of the Liver Cancer Study Group of Japan. Cancer 122:61–70

    Article  Google Scholar 

  12. Amin MB, Edge S, Greene F et al (eds) (2017) AJCC cancer staging manual, 8th edn. Springer, New York

    Google Scholar 

  13. Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 40:205–213

    Article  Google Scholar 

  14. Yoh T, Seo S, Hatano E et al (2017) A novel biomarker-based preoperative prognostic grading system for predicting survival after surgery for intrahepatic cholangiocarcinoma. Ann Surg Oncol 24:1351–1357

    Article  PubMed  Google Scholar 

  15. Yoh T, Hatano E, Seo S et al (2018) Long-term survival of recurrent intrahepatic cholangiocarcinoma: the impact and selection of repeat surgery. World J Surg 42:1848–1856. https://doi.org/10.1007/s00268-017-4387-7

    Article  PubMed  Google Scholar 

  16. Jiang L, Tan H, Panje CM et al (2016) Role of 18F-FDG PET/CT imaging in intrahepatic cholangiocarcinoma. Clin Nucl Med 41:1–7

    Article  PubMed  Google Scholar 

  17. Ma KW, Cheung TT, She WH et al (2017) Diagnostic and prognostic role of 18-FDG PET/CT in the management of resectable biliary tract cancer. World J Surg. https://doi.org/10.1007/s00268-017-4192-3

    Article  PubMed  Google Scholar 

  18. (2017) Capecitabine extends survival for biliary tract cancer. Cancer Discov 7:OF1. https://doi.org/10.1158/2159-8290.CD-NB2017-079

  19. Park TG, Yu YD, Park BJ et al (2014) Implication of lymph node metastasis detected on 18F-FDG PET/CT for surgical planning in patients with peripheral intrahepatic cholangiocarcinoma. Clin Nucl Med 39:1–7

    Article  PubMed  Google Scholar 

  20. Park MS, Lee SM (2014) Preoperative 18F-FDG PET-CT maximum standardized uptake value predicts recurrence of biliary tract cancer. Anticancer Res 34:2551–2554

    PubMed  Google Scholar 

Download references

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Correspondence to Satoru Seo.

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Yoh, T., Seo, S., Morino, K. et al. Reappraisal of Prognostic Impact of Tumor SUVmax by 18F-FDG-PET/CT in Intrahepatic Cholangiocarcinoma. World J Surg 43, 1323–1331 (2019). https://doi.org/10.1007/s00268-019-04917-z

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