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01-02-2018 | Original Article

18-Fluorodeoxyglucose Positron Emission Tomography Predicts Recurrence in Resected Pancreatic Ductal Adenocarcinoma

Authors: Kyohei Ariake, Fuyuhiko Motoi, Hideo Shimomura, Masamichi Mizuma, Shimpei Maeda, Chiaki Terao, Yasuko Tatewaki, Hideo Ohtsuka, Koji Fukase, Kunihiro Masuda, Hiroki Hayashi, Tatsuyuki Takadate, Takeshi Naitoh, Yasuyuki Taki, Michiaki Unno

Published in: Journal of Gastrointestinal Surgery | Issue 2/2018

Abstract

Background

We aimed to determine whether treatment should be stratified according to 18-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) maximum standardized uptake values (SUV_max) in pancreatic ductal adenocarcinoma.

Methods

Patients who underwent preoperative 18F-FDG PET/CT between 2006 and 2014 (n = 138) were stratified into high (≥ 4.85) and low (< 4.85) PET groups. The clinicopathological characteristics and prognostic outcomes were analyzed retrospectively.

Results

The primary tumor SUV_max was positively correlated with preoperative CA19-9 levels (P < 0.001). The high PET group failed to achieve postoperative CA19-9 normalization (P = 0.014). Disease-specific (P < 0.001), recurrence-free (P < 0.001), liver recurrence-free (P < 0.001), and peritoneal recurrence-free (P = 0.020) survivals were significantly shorter in the high PET group. The primary tumor SUV_max was an independent predictive risk factor for liver metastasis (hazard ratio 3.46, 95% confidence interval 1.61–7.87; P = 0.001) and peritoneal recurrence (hazard ratio 3.36, 95% confidence interval 1.18–10.89; P = 0.023).

Conclusions

Surgical resection failed to achieve CA19-9 normalization in the high PET group and distant recurrence was frequent. This suggests the potential for residual cancer at distant sites, even after curative resection. Stronger preoperative systemic chemotherapy is preferred for the high PET group patients.

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Title: 18-Fluorodeoxyglucose Positron Emission Tomography Predicts Recurrence in Resected Pancreatic Ductal Adenocarcinoma
Authors: Kyohei Ariake
Fuyuhiko Motoi
Hideo Shimomura
Masamichi Mizuma
Shimpei Maeda
Chiaki Terao
Yasuko Tatewaki
Hideo Ohtsuka
Koji Fukase
Kunihiro Masuda
Hiroki Hayashi
Tatsuyuki Takadate
Takeshi Naitoh
Yasuyuki Taki
Michiaki Unno
Publication date: 01-02-2018
Publisher: Springer US
Published in: Journal of Gastrointestinal Surgery / Issue 2/2018
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-017-3627-3

At a glance: The STEP trials

Springer Medicine

18-Fluorodeoxyglucose Positron Emission Tomography Predicts Recurrence in Resected Pancreatic Ductal Adenocarcinoma

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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