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Prognostic and predictive value of metabolic tumor volume on 18F-FDG PET/CT in advanced biliary tract cancer treated with gemcitabine/oxaliplatin with or without erlotinib

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Abstract

This study aimed to evaluate the prognostic significance and predictive performance of volume-based parameter of 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) in biliary tract cancer (BTC). Of the 268 patients who were enrolled onto phase III gemcitabine/oxaliplatin (GEMOX) versus GEMOX/erlotinib trial, a total of 48 patients had pretreatment 18F-FDG PET/CT available for analysis. Maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), and total lesion glycolysis for the primary tumor were measured. The prognostic significance of these parameters and clinicopathological variables was assessed by Cox proportional hazards regression analysis. A cutoff of 98.8 ml for the MTVliver was the best discriminative value for predicting overall survival (>9 months). Multivariate analyses with adjustments for age, performance status, and disease status showed that only MTVliver was an independent prognostic factor associated with overall survival (HR 2.149, 95 % CI 1.124–4.109, P = 0.021). SUVmax did not show any correlation with overall survival. For patients in the high-MTVMBP group, overall survival was longer in the chemotherapy plus erlotinib group than in the chemotherapy-alone group [median 8.3 months (5.5–11.1) vs. 4.0 months (0.0–8.0); P = 0.048]. MTV may be considered as a significant independent metabolic prognostic factor for overall survival in patients with BTC and predictive marker for the selection of patients for the addition of erlotinib to first-line chemotherapy.

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Authors and Affiliations

  1. Division of Hematology–Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, Seoul, 135-710, Korea

    Moon Ki Choi, Jeeyun Lee, Joon Oh Park, Young Suk Park & Ho Yeong Lim

  2. Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, Seoul, 135-710, Korea

    Joon Young Choi

  3. Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

    Jin Seok Heo, Seong Ho Choi & Dong Wook Choi

  4. Division of Gastroenterology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

    Kyu Taek Lee, Jong Kyun Lee & Kwang Hyuck Lee

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  1. Moon Ki Choi
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Correspondence to Joon Young Choi or Ho Yeong Lim.

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Moon Ki Choi and Joon Young Choi are co-first authors.

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Choi, M.K., Choi, J.Y., Lee, J. et al. Prognostic and predictive value of metabolic tumor volume on 18F-FDG PET/CT in advanced biliary tract cancer treated with gemcitabine/oxaliplatin with or without erlotinib. Med Oncol 31, 23 (2014). https://doi.org/10.1007/s12032-014-0023-7

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  • DOI: https://doi.org/10.1007/s12032-014-0023-7

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