Department of Surgery, Universita' Politecnica delle Marche, Ancona, Italy.
Pancreatic Surgery Unit, Pancreas Translational & Clinical Research Center, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Dig Liver Dis. 2018 Jan;50(1):84-90. doi: 10.1016/j.dld.2017.09.122. Epub 2017 Sep 22.
(18)fluoro-deoxyglucose positron emission tomography/computed tomography (18FDG-PET/CT) might be a useful tool in the management of pancreatic ductal adenocarcinoma (PDAC).
The aim of this study was to analyze maximum standard uptake value (SUVmax) after 18FDG-PET/CT as predictor of survival outcomes and method to determine treatment strategies.
A consecutive series of patients who underwent preoperative 18FDG-PET/CT and subsequent resection for PDAC were retrospectively reviewed. Patients who underwent neoadjuvant chemotherapy were excluded.
46 patients were included in the analysis. Median follow-up was 27 months (4-67). Patients who recurred within 12 months showed a significantly higher preoperative median SUVmax (8.1 vs 6.1, p=0.039). Receiver operating characteristics (ROC) curves for disease-free survival (DFS) and disease-specific survival (DSS) identified SUVmax of 6.0 as optimal cut-off. Multivariate analysis showed that SUVmax ≥ 6.0 was an independent predictor of poor DFS (HR 2.288, p=0.024) and DSS (HR 4.875, p<0.001). The combination of SUVmax ≥6.0 with CA19.9 ≥200U/ml was significantly associated with survival outcomes in comparison to patients without concordantly elevated values.
SUVmax ≥6.0 is an independent predictor of DFS and DSS in resected PDAC. 18FDG-PET/CT might be considered in the preoperative evaluation of patients with pancreatic cancer.
（18）氟代脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（18FDG-PET/CT）可能是胰腺导管腺癌（PDAC）管理的有用工具。
本研究旨在分析 18FDG-PET/CT 后最大标准摄取值（SUVmax）作为生存结果的预测因子，并确定治疗策略的方法。
回顾性分析了连续系列接受术前 18FDG-PET/CT 检查并随后接受 PDAC 切除术的患者。排除接受新辅助化疗的患者。
46 例患者纳入分析。中位随访时间为 27 个月（4-67）。12 个月内复发的患者术前中位 SUVmax 显著较高（8.1 与 6.1，p=0.039）。无病生存（DFS）和疾病特异性生存（DSS）的受试者工作特征（ROC）曲线确定 SUVmax 为 6.0 为最佳截断值。多变量分析显示，SUVmax≥6.0 是 DFS（HR 2.288，p=0.024）和 DSS（HR 4.875，p<0.001）不良的独立预测因子。与无一致升高值的患者相比，SUVmax≥6.0 与 CA19.9≥200U/ml 的组合与生存结果显著相关。
SUVmax≥6.0 是可切除 PDAC 患者 DFS 和 DSS 的独立预测因子。18FDG-PET/CT 可能在胰腺癌患者的术前评估中被考虑。
