Prognostic significance of standardized uptake value on preoperative 18F-FDG PET/CT in patients with ampullary adenocarcinoma
- 353 Downloads
The purpose of this study was to investigate the prognostic value of 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) in patients with ampullary adenocarcinoma (AAC) after curative surgical resection.
Fifty-two patients with AAC who had undergone 18F-FDG PET/CT and subsequent curative resections were retrospectively enrolled. The maximum standardized uptake value (SUVmax) and tumor to background ratio (TBR) were measured on 18F-FDG PET/CT in all patients. The prognostic significances of PET/CT parameters and clinicopathologic factors for recurrence-free survival (RFS) and overall survival (OS) were evaluated by univariate and multivariate analyses.
Of the 52 patients, 19 (36.5 %) experienced tumor recurrence during the follow-up period and 18 (35.8 %) died. The 3-year RFS and OS were 62.3 and 61.5 %, respectively. Preoperative CA19-9 level, tumor differentiation, presence of lymph node metastasis, SUVmax, and TBR were significant prognostic factors for both RFS and OS (p < 0.05) on univariate analyses, and patient age showed significance only for predicting RFS (p < 0.05). On multivariate analyses, SUVmax and TBR were independent prognostic factors for RFS, and tumor differentiation, SUVmax, and TBR were independent prognostic factors for OS.
SUVmax and TBR on preoperative 18F-FDG PET/CT are independent prognostic factors for predicting RFS and OS in patients with AAC; patients with high SUVmax (>4.80) or TBR (>1.75) had poor survival outcomes. The role of and indications for adjuvant therapy after curative resection of AAC are still unclear. 18F-FDG uptake in the primary tumor could provide additive prognostic information for the decision-making process regarding adjuvant therapy.
KeywordsAmpullary adenocarcinoma Ampulla of Vater Prognosis 18F-Fluorodeoxyglucose Positron emission tomography Standardized uptake value
This study was supported by a new faculty research seed money grant of Yonsei University College of Medicine for 2014 (2014-32-0026).
Conflicts of interest
- 7.Robert PE, Leux C, Ouaissi M, Miguet M, Paye F, Merdrignac A, et al. Predictors of long-term survival following resection for ampullary carcinoma: a large retrospective French multicentric study. Pancreas 2014;43:692–7.Google Scholar
- 9.Kurihara C, Yoshimi F, Sasaki K, Iijima T, Kawasaki H, Nagai H. Clinical value of serum CA19-9 as a prognostic factor for the ampulla of Vater carcinoma. Hepatogastroenterology. 2013;60:1588–91.Google Scholar
- 20.Neoptolemos JP, Moore MJ, Cox TF, Valle JW, Palmer DH, McDonald AC, et al. Effect of adjuvant chemotherapy with fluorouracil plus folinic acid or gemcitabine vs observation on survival in patients with resected periampullary adenocarcinoma: the ESPAC-3 periampullary cancer randomized trial. JAMA 2012;308:147–56.CrossRefPubMedGoogle Scholar
- 28.Park KW, Ashlock R, Chang WB, Lahner J, Line B, Kim C. High variation in standardized uptake values among PET systems from different manufacturers. J Nucl Med 2007;48(Suppl 2):185P.Google Scholar
- 32.Dholakia AS, Chaudhry M, Leal JP, Chang DT, Raman SP, Hacker-Prietz A, et al. Baseline metabolic tumor volume and total lesion glycolysis are associated with survival outcomes in patients with locally advanced pancreatic cancer receiving stereotactic body radiation therapy. Int J Radiat Oncol Biol Phys 2014;89:539–46.Google Scholar