Barnes Chad A, Aldakkak Mohammed, Clarke Callisia N, Christians Kathleen K, Bucklan Daniel, Holt Michael, Tolat Parag, Ritch Paul S, George Ben, Hall William A, Erickson Beth A, Evans Douglas B, Tsai Susan
LaBahn Pancreatic Cancer Program, Department of Surgery, The Medical College of Wisconsin, Milwaukee, WI, United States.
Department of Radiology, The Medical College of Wisconsin, Milwaukee, WI, United States.
Front Oncol. 2020 Apr 17;10:500. doi: 10.3389/fonc.2020.00500. eCollection 2020.
F-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) imaging is not routine in patients with localized pancreatic cancer (PC). We evaluated the prognostic value of PET/CT in patients who received neoadjuvant therapy. Patients with localized PC underwent pretreatment PET/CT with or without posttreatment (preop) PET/CT. Maximum standardized uptake values (SUV) were classified as high or low based on a cut point of 7.5 at diagnosis (SUV) and 3.5 after neoadjuvant therapy (preoperative; SUV). Preop carbohydrate antigen 19-9 (CA19-9) was classified as normal ( ≤ 35 U/mL) or elevated. Pretreatment PET/CT imaging was performed on 201 consecutive patients; SUV was high in 98 (49%) and low in 103 (51%). Preop PET/CT was available in 104 (52%) of the 201 patients; SUV was high in 60 (58%) and low in 44 (42%). Following neoadjuvant therapy, preop CA19-9 was normal in 90 (45%) patients and elevated in 111 (55%). Median overall survival (OS) of all patients was 27 months; 33 months for the 103 patients with a low SUV and 22 months for the 98 patients with a high SUV ( = 0.03). Median OS for patients with low SUV/normal preop CA19-9, high SUV/normal preop CA19-9, low SUV/elevated preop CA19-9, and high SUV/elevated preop CA19-9 were 66, 34, 23, and 17 months, respectively ( < 0.0001). OS was 44 months for the 148 (74%) patients who completed all intended neoadjuvant therapy and surgery and 13 months for the 53 (26%) who did not undergo surgery ( < 0.001). Pretreatment PET/CT avidity and preop CA19-9 are clinically significant prognostic markers in patients with PC.
F-氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（PET/CT）成像在局限性胰腺癌（PC）患者中并非常规检查。我们评估了PET/CT在接受新辅助治疗患者中的预后价值。局限性PC患者在治疗前接受了PET/CT检查，部分患者还接受了治疗后（术前）PET/CT检查。根据诊断时SUV值的切点为7.5以及新辅助治疗后（术前；SUV）的切点为3.5，将最大标准化摄取值（SUV）分为高或低。术前糖类抗原19-9（CA19-9）分为正常（≤35 U/mL）或升高。对201例连续患者进行了治疗前PET/CT成像；98例（49%）的SUV值高，103例（51%）的SUV值低。201例患者中有104例（52%）可获得术前PET/CT；60例（58%）的SUV值高，44例（42%）的SUV值低。新辅助治疗后，90例（45%）患者的术前CA19-9正常，111例（55%）患者的术前CA19-9升高。所有患者的中位总生存期（OS）为27个月；103例SUV值低的患者为33个月，98例SUV值高的患者为22个月（P = 0.03）。SUV值低/术前CA19-9正常、SUV值高/术前CA19-9正常、SUV值低/术前CA19-9升高以及SUV值高/术前CA19-9升高患者的中位OS分别为66、34、23和17个月（P < 0.0001）。148例（74%）完成所有预定新辅助治疗和手术的患者的OS为44个月，53例（26%）未接受手术的患者的OS为13个月（P < 0.001）。治疗前PET/CT的摄取情况和术前CA19-9是PC患者具有临床意义的预后标志物。
