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18-Fluorodeoxyglucose Positron Emission Tomography Predicts Recurrence in Resected Pancreatic Ductal Adenocarcinoma

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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background

We aimed to determine whether treatment should be stratified according to 18-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) maximum standardized uptake values (SUVmax) in pancreatic ductal adenocarcinoma.

Methods

Patients who underwent preoperative 18F-FDG PET/CT between 2006 and 2014 (n = 138) were stratified into high (≥ 4.85) and low (< 4.85) PET groups. The clinicopathological characteristics and prognostic outcomes were analyzed retrospectively.

Results

The primary tumor SUVmax was positively correlated with preoperative CA19-9 levels (P < 0.001). The high PET group failed to achieve postoperative CA19-9 normalization (P = 0.014). Disease-specific (P < 0.001), recurrence-free (P < 0.001), liver recurrence-free (P < 0.001), and peritoneal recurrence-free (P = 0.020) survivals were significantly shorter in the high PET group. The primary tumor SUVmax was an independent predictive risk factor for liver metastasis (hazard ratio 3.46, 95% confidence interval 1.61–7.87; P = 0.001) and peritoneal recurrence (hazard ratio 3.36, 95% confidence interval 1.18–10.89; P = 0.023).

Conclusions

Surgical resection failed to achieve CA19-9 normalization in the high PET group and distant recurrence was frequent. This suggests the potential for residual cancer at distant sites, even after curative resection. Stronger preoperative systemic chemotherapy is preferred for the high PET group patients.

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Acknowledgements

We would like to thank for Editage (www.editage.com) for English language editing and publication support.

Funding

This study was supported by a Grant-in-Aid for Young Scientists (B) (grant no. 16K19911) from the Japan Society for the Promotion of Science.

Author information

Authors and Affiliations

  1. Department of Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan

    Kyohei Ariake, Fuyuhiko Motoi, Masamichi Mizuma, Shimpei Maeda, Hideo Ohtsuka, Koji Fukase, Kunihiro Masuda, Hiroki Hayashi, Tatsuyuki Takadate, Takeshi Naitoh & Michiaki Unno

  2. Division of Nuclear Medicine and Radiology, Institute of Development, Aging, and Cancer, Tohoku University, Sendai, Japan

    Hideo Shimomura, Chiaki Terao, Yasuko Tatewaki & Yasuyuki Taki

Authors
  1. Kyohei Ariake
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  2. Fuyuhiko Motoi
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  3. Hideo Shimomura
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  4. Masamichi Mizuma
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  9. Koji Fukase
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  11. Hiroki Hayashi
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  12. Tatsuyuki Takadate
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  13. Takeshi Naitoh
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  14. Yasuyuki Taki
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  15. Michiaki Unno
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Contributions

Study conception and design: KA, FM, MM, YT

Acquisition of data: KA, FM, SM, HS, CT

Analysis and interpretation of the data: KA, FM, YT, HS

Drafting of the manuscript: KA

Critical revision of the manuscript: HO, KF, KM, HH, TT, TN

All the authors have read and approved the final version of the manuscript and have agreed to be accountable for all aspects of the study, ensuring that any questions related to the accuracy or integrity of any part of the work are answerable.

Corresponding author

Correspondence to Kyohei Ariake.

Ethics declarations

This study was approved by the Institutional Review Board of Tohoku University (Sendai, Japan) on December 14, 2016. The requirement of informed consent was waived and an opt-out method was used due to the retrospective design of the study. The research was conducted in accordance with the Declaration of Helsinki.

Conflict of Interest

The authors declare that they have no conflicts of interest.

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Ariake, K., Motoi, F., Shimomura, H. et al. 18-Fluorodeoxyglucose Positron Emission Tomography Predicts Recurrence in Resected Pancreatic Ductal Adenocarcinoma. J Gastrointest Surg 22, 279–287 (2018). https://doi.org/10.1007/s11605-017-3627-3

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  • DOI: https://doi.org/10.1007/s11605-017-3627-3

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