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Preoperative FDG-PET Predicts Early Recurrence and a Poor Prognosis After Resection of Pancreatic Adenocarcinoma

  • Pancreatic Tumors
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Objective

The aim of this study was to evaluate the clinical utility of preoperative 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) as a prognostic predictor of resectable pancreatic adenocarcinoma.

Methods

A total of 128 patients with resected pancreatic adenocarcinoma who preoperatively underwent FDG-PET examinations were studied. The maximum standard uptake value (SUVmax) was calculated for each primary lesion. A receiver operating characteristics (ROC) curve was constructed to estimate the optimal cutoff value of the SUVmax. In order to determine which outcomes of interest were appropriately demonstrated, ROC curve analyses were conducted for six outcomes: 6-, 12-, and 24-month disease-free survival (DFS), and 6-, 12-, and 24-month overall survival (OS). A multivariate analysis was conducted to identify prognostic factors.

Results

The ROC curves revealed that the SUVmax predicted the 6-month DFS most optimally (area under the curve 0.757), with a cutoff value of 6.0. Of the 69 patients with an SUVmax ≥ 6.0, 34 (49 %) developed recurrence within 6 months. In contrast, only 3 of 59 (5 %) patients with an SUVmax < 6.0 exhibited early recurrence (p < 0.001). The median OS time was 37 months in patients with an SUVmax < 6.0 and 18 months in patients with an SUVmax ≥ 6.0 (p < 0.001). The multivariate analysis revealed lymph node metastasis (hazard ratio [HR] 2.31; p = 0.001) and an SUVmax ≥ 6.0 (HR 2.05; p = 0.002) to be significantly correlated with a poor survival.

Conclusions

An SUVmax ≥ 6.0 was a significant predictor of early postoperative recurrence and subsequent poor survival following resection of pancreatic adenocarcinoma.

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Disclosure

Tatsuma Yamamoto, Teiichi Sugiura, Takashi Mizuno, Yukiyasu Okamura, Takeshi Aramaki, Masahiro Endo, and Katsuhiko Uesaka declare no financial or other types of support.

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Authors and Affiliations

  1. Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Center, Shizuoka, Japan

    Tatsuma Yamamoto MD, Teiichi Sugiura MD, Takashi Mizuno MD, Yukiyasu Okamura MD & Katsuhiko Uesaka MD

  2. Division of Diagnostic Radiology, Shizuoka Cancer Center, Shizuoka, Japan

    Takeshi Aramaki MD & Masahiro Endo MD

Authors
  1. Tatsuma Yamamoto MD
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  2. Teiichi Sugiura MD
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  3. Takashi Mizuno MD
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  4. Yukiyasu Okamura MD
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  7. Katsuhiko Uesaka MD
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Correspondence to Teiichi Sugiura MD.

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Yamamoto, T., Sugiura, T., Mizuno, T. et al. Preoperative FDG-PET Predicts Early Recurrence and a Poor Prognosis After Resection of Pancreatic Adenocarcinoma. Ann Surg Oncol 22, 677–684 (2015). https://doi.org/10.1245/s10434-014-4046-2

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  • DOI: https://doi.org/10.1245/s10434-014-4046-2

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