Prognostic Value of 18F-Fluorodeoxyglucose Positron Emission Tomography in Patients with Resectable Pancreatic Cancer
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Purpose: We evaluated the prognostic value of 18F-2-fluoro-2-deoxyglucose positron emission tomography (FDG PET) in patients with resectable pancreatic cancer. Materials and Methods: We retrospectively reviewed the medical records of pancreatic cancer patients who underwent curative resection, which included 64 consecutive patients who had preoperative FDG PET scans. For statistical analysis, the maximal standardized uptake value (SUVmax) of primary pancreatic cancer was measured. Survival time was estimated by the Kaplan-Meier method, and Cox’s proportional hazard model was used to determine whether SUVmax added new predictive information concerning survival together with known prognostic factors. p<0.05 indicated statistical significance. Results: Overall survival (OS) and disease-free survival (DFS) were respectively 42.9 months (27.6-58.2; 95% CI) and 14.9 months (10.1-19.7; 95% CI). When subjects were divided into two groups according to SUVmax with a cutoff value of 3.5, the high SUVmax group (n=32; SUVmax >3.5) showed significantly shorter OS and DFS than the low SUVmax group. Multivariate analysis of OS and DFS showed that both high SUVmax and poor tumor differentiation were independent poor prognostic factors. Conclusion: Our study showed that degree of FDG uptake was an independent prognostic factor in pancreatic cancer patients who underwent curative resection.
Abstract
Purpose: We evaluated the prognostic value of 18F-2-fluoro-2-deoxyglucose positron emission tomography (FDG PET) in patients with resectable pancreatic cancer. Materials and Methods: We retrospectively reviewed the medical records of pancreatic cancer patients who underwent curative resection, which included 64 consecutive patients who had preoperative FDG PET scans. For statistical analysis, the maximal standardized uptake value (SUVmax) of primary pancreatic cancer was measured. Survival time was estimated by the Kaplan-Meier method, and Cox’s proportional hazard model was used to determine whether SUVmax added new predictive information concerning survival together with known prognostic factors. p<0.05 indicated statistical significance. Results: Overall survival (OS) and disease-free survival (DFS) were respectively 42.9 months (27.6-58.2; 95% CI) and 14.9 months (10.1-19.7; 95% CI). When subjects were divided into two groups according to SUVmax with a cutoff value of 3.5, the high SUVmax group (n=32; SUVmax >3.5) showed significantly shorter OS and DFS than the low SUVmax group. Multivariate analysis of OS and DFS showed that both high SUVmax and poor tumor differentiation were independent poor prognostic factors. Conclusion: Our study showed that degree of FDG uptake was an independent prognostic factor in pancreatic cancer patients who underwent curative resection.
참고문헌 (32)
- Li D, "Pancreatic cancer", Lancet, 363, pp.1049~1057 (2004)
- Yeo CJ, "Pancreaticoduodenectomy for cancer of the head of the pancreas. 201 patients", Ann Surg, 221, pp.721~731 (1995)
- Bang S, "The clinical usefulness of 18-fluorodeoxyglucose positron emission tomography in the differential diagnosis, staging, and response evaluation after concurrent chemoradiotherapy for pancreatic cancer", J Clin Gastroenterol, 40, pp.923~929 (2006)
- Humphris JL, "The prognostic and predictive value of serum CA19.9 in pancreatic cancer", Ann Oncol, 23, pp.1713~1722 (2012)
- 이경주, "Serum CA 19-9 and CEA Levels as a Prognostic Factor in Pancreatic Adenocarcinoma", Yonsei Medical Journal, 54(3), pp.643~649 (2013), 연세대학교의과대학[DOI]
- Lim JE, "Prognostic factors following curative resection for pancreatic adenocarcinoma: a population-based, linked database analysis of 396 patients", Ann Surg, 237, pp.74~85 (2003)
- Sohn TA, "Resected adenocarcinoma of the pancreas-616 patients: results, outcomes, and prognostic indicators", J Gastrointest Surg, 4, pp.567~579 (2000)
- Ueda M, "Prognostic factors after resection of pancreatic cancer", World J Surg, 33, pp.104~110 (2009)
- Kauhanen SP, "A prospective diagnostic accuracy study of 18F-fluorodeoxyglucose positron emission tomography", computed tomography, multidetector row computed tomography, and magnetic resonance imaging in primary diagnosis and staging of pancreatic cancer, 2009, pp.250, 957~963
- Zimny M, "Fluorodeoxyglucose positron emission tomography and the prognosis of pancreatic carcinoma", Scand J Gastroenterol, 35, pp.883~888 (2000)
- Nakata B, "Prognostic predictive value of 18F-fluorodeoxyglucose positron emission tomography for patients with pancreatic cancer", Int J Oncol, 19, pp.53~58 (2001)
- Sperti C, "18-Fluorodeoxyglucose positron emission tomography in predicting survival of patients with pancreatic carcinoma", J Gastrointest Surg, 7, pp.953~959 (2003)
- Lyshchik A, "Dual-phase 18F-fluoro-2-deoxy-D-glucose positron emission tomography as a prognostic parameter in patients with pancreatic cancer", Eur J Nucl Med Mol Imaging, 32, pp.389~397 (2005)
- Maemura K, "Role of positron emission tomography in decisions on treatment strategies for pancreatic cancer", J Hepatobiliary Pancreat Surg, 13, pp.435~441 (2006)
- Lee SM, "Improved prognostic value of standardized uptake value corrected for blood glucose level in pancreatic cancer using F-18 FDG PET", Clin Nucl Med, 36, pp.331~336 (2011)
- Choi M, "Using 18F-fluorodeoxyglucose positron emission tomography to monitor clinical outcomes in patients treated with neoadjuvant chemo-radiotherapy for locally advanced pancreatic cancer", Am J Clin Oncol, 33, pp.257~261 (2010)
- Kuwatani M, "Modalities for evaluating chemotherapeutic efficacy and survival time in patients with advanced pancreatic cancer: comparison between FDG-PET, CT, and serum tumor markers", Intern Med, 48, pp.867~875 (2009)
- Higashi T, "Diagnosis of pancreatic cancer using fluorine-18 fluorodeoxyglucose positron emission tomography (FDG PET) --usefulness and limitations in “clinical reality”", Ann Nucl Med, 17, pp.261~279 (2003)
- Reske SN, "Clinical value of positron emission tomography (PET) in oncologic questions: results of an interdisciplinary consensus conference. Schirmerreschaft der Deutschen Gesellschaft for Nuklearmedizin", Nuklearmedizin, 35, pp.42~52 (1996)
- Lyshchik A, "Expression of glucose transporter-1, hexokinase-II, proliferating cell nuclear antigen and survival of patients with pancreatic cancer", Cancer Invest, 25, pp.154~162 (2007)
- Wakabayashi H, "Role of 18F-fluorodeoxyglucose positron emission tomography imaging in surgery for pancreatic cancer", World J Gastroenterol, 14, pp.64~69 (2008)
- Jamieson NB, "Tissue biomarkers for prognosis in pancreatic ductal adenocarcinoma: a systematic review and meta-analysis", Clin Cancer Res, 17, pp.3316~3331 (2011)
- Bley TA, "Diagnostic accuracy of MRI for preoperative staging of pancreatic carcinoma: tendency for understaging", In Vivo, 19, pp.983~987 (2005)
- Soriano A, "Preoperative staging and tumor resectability assessment of pancreatic cancer: prospective study comparing endoscopic ultrasonography, helical computed tomography, magnetic resonance imaging, and angiography", Am J Gastroenterol, 99, pp.492~501 (2004)
- Kapoor V, "An introduction to PET-CT imaging", Radiographics, 24, pp.523~543 (2004)
- Hany TF, "PET diagnostic accuracy: improvement with in-line PET-CT system: initial results", Radiology, 225, pp.575~581 (2002)
- FDG PET, "CT with PET alone and with side-by-side PET and CT in patients with malignant melanoma", Eur J Nucl Med Mol Imaging, 34, pp.1355~1364 (2007)
- Halpern BS, "Evaluation of suspected local recurrence in head and neck cancer: a comparison between PET and PET", CT for biopsy proven lesions, 2007, pp.62, 199~204
- Freudenberg LS, "PET versus PET", CT dual-modality imaging in evaluation of lung cancer, 2007, pp.45, 639~644
- Kim JH, "Comparison between 18F-FDG PET, in-line PET", CT, and software fusion for restaging of recurrent colorectal cancer, 2005, pp.46, 587~595
- Tang S, "Usefulness of 18F-FDG PET, combined FDG-PET", CT and EUS in diagnosing primary pancreatic carcinoma: a meta-analysis, 2011, pp.78, 142~150
- Buchs NC, "Value of contrast-enhanced 18F-fluorodeoxyglucose positron emission tomography", computed tomography in detection and presurgical assessment of pancreatic cancer: a prospective study, 2011, pp.26, 657~662