The role of 18F-fluorodeoxyglucose positron emission tomography/computed tomography–derived parameters as prognostic factors in patients undergoing resection for pancreatic ductal adenocarcinoma
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Abstract
Background
The aim of this study is to investigate the role of maximum standardized uptake and tumor-to-liver ratio derived from preoperative 18F-fluorodeoxyglucose positron emission tomography/computed tomography in patients with pancreatic ductal adenocarcinoma.
Methods
Patients who underwent pancreatic resection from January 2015 to December 2022 were reviewed. Patients were grouped based on disease-free survival of 1 year, disease-free survival of 6 months, overall survival of 1 year, and resectability.
Results
A total of 133 patients were included in the study. The median maximum standardized uptake was significantly greater in patients with shorter survival than in those with longer survival (disease-free survival <1 year vs >1 year: 7.1 [4.3–9.1] vs 4.9 [3.3–6.5], P < .001; disease-free survival <6 months vs >6 months: 8 [4.5–9.7] vs 5.2 [3.4–6.8], P = .001; overall survival <1 year vs >1 year: 6.9 [4.4–8.8] vs 5 [3.4–6.9], P = .01). Median maximum standardized uptake was significantly greater in patients with intraoperative findings of unresectable disease than in those who underwent surgical resection (7.4 [5.5–9.5] vs 5.5 [3.8–7.8], P = .02). These findings were consistent for tumor-to-liver ratio for all groupings. The area under the curve based on receiver operating characteristic analysis was 0.7 for both maximum standardized uptake and tumor-to-liver ratio for predicting disease-free survival, overall survival, and resectability.
Conclusion
Preoperative 18F-fluorodeoxyglucose positron emission tomography/computed tomography maximum standardized uptake and tumor-to-liver ratio are indicators of resectability, early recurrence, and poor prognosis in patients with pancreatic ductal adenocarcinoma. A maximum standardized uptake value between 5 and 7 is a potential red flag, and further investigations should be considered before proceeding to a pancreatic resection.
期刊介绍：
For 66 years, Surgery has published practical, authoritative information about procedures, clinical advances, and major trends shaping general surgery. Each issue features original scientific contributions and clinical reports. Peer-reviewed articles cover topics in oncology, trauma, gastrointestinal, vascular, and transplantation surgery. The journal also publishes papers from the meetings of its sponsoring societies, the Society of University Surgeons, the Central Surgical Association, and the American Association of Endocrine Surgeons.
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