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Published in: BMC Cancer 1/2019

Open Access 01-12-2019 | Research article

Preoperative maximum standardized uptake value and carbohydrate antigen 19–9 were independent predictors of pathological stages and overall survival in Chinese patients with pancreatic duct adenocarcinoma

Authors: Xinjin Gu, Ruiquan Zhou, Chenggang Li, Rong Liu, Zhiming Zhao, Yuanxing Gao, Yong Xu

Published in: BMC Cancer | Issue 1/2019

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Abstract

Background

Purpose of this study was to analyze whether preoperative maximum standardized uptake value (SUVmax) and carbohydrate antigen 19–9 (CA19–9) levels might provide prognostic information in Chinese patients with pancreatic duct adenocarcinoma (PDAC) after pancreaticoduodenectomy (PD).

Methods

Standard PD was performed on 109 patients with PDAC by the same operative team, and all patients received preoperative positron emission tomography/computed tomography examination and blood test.

Results

Patients had a mean age of 59 ± 9.35 years. Females accounted for 38.5%. Mean levels of SUVmax, carcino-embryonic antigen (CEA) and CA19–9 were 5.70 ± 2.76, 3.95 ± 4.16ng/mL and 321.62 ± 780.71kU/L. In univariate Logistic regression analysis, preoperative SUVmax, CEA and CA19–9 levels (p < 0.05 for all) rather than other preoperative variables (p > 0.05 for all) were significantly related to AJCC stages. Multivariate Logistic regression analysis showed that preoperative SUVmax and CA19–9 levels (p < 0.05 for all) rather than other preoperative variables (p > 0.05 for all) were significantly associated with AJCC stages. Mean overall survival (OS) was 21 ± 14.50 months. In univariate Cox regression analysis, age, SUVmax, CEA and CA19–9 levels before operation (p < 0.05 for all) rather than other preoperative variables (p > 0.05 for all) were significantly related to OS. Multivariate Cox regression analysis showed that age, SUVmax and CA19–9 levels before operation (p < 0.05 for all) rather than other preoperative variables (p > 0.05 for all) were significantly associated with OS.

Conclusions

This study demonstrated that preoperative SUVmax and CA19–9 levels independently predicted pathological stages and OS of patients with PDAC after PD. These preoperative variables might have significant prognostic implication in patients with PDAC after PD. Patients with abnormal SUVmax and CA19–9 levels should be paid special attention to in operative strategy and perioperative management.
Literature
1.
go back to reference Siegel RL, Miller KD, Jemal A. Cancer statistics, 2016. CA Cancer J Clin. 2016;66:7–30.CrossRef Siegel RL, Miller KD, Jemal A. Cancer statistics, 2016. CA Cancer J Clin. 2016;66:7–30.CrossRef
2.
go back to reference Okano K, Suzuki Y. Strategies for early detection of resectable pancreatic cancer. World J Gastroenterol. 2014;20:11230–40.CrossRef Okano K, Suzuki Y. Strategies for early detection of resectable pancreatic cancer. World J Gastroenterol. 2014;20:11230–40.CrossRef
3.
go back to reference Schnelldorfer T, Ware AL, Sarr MG, et al. Longterm survival after pancreatoduodenectomy for pancreatic adenocarcinoma: is cure possible? Ann Surg. 2008;247:456–62.CrossRef Schnelldorfer T, Ware AL, Sarr MG, et al. Longterm survival after pancreatoduodenectomy for pancreatic adenocarcinoma: is cure possible? Ann Surg. 2008;247:456–62.CrossRef
4.
go back to reference Adham M, Jaeck D, Le Borgne J, et al. Longterm survival (5-20 years) after pancreatectomy for pancreatic ductal adenocarcinoma: a series of 30 patients collected from three institutions. Pancreas. 2008;37:352–7.CrossRef Adham M, Jaeck D, Le Borgne J, et al. Longterm survival (5-20 years) after pancreatectomy for pancreatic ductal adenocarcinoma: a series of 30 patients collected from three institutions. Pancreas. 2008;37:352–7.CrossRef
5.
go back to reference Katz MH, Wang H, Fleming JB, et al. Longterm survival after multidisciplinary management of resected pancreatic adenocarcinoma. Ann Surg Oncol. 2009;16:836–47.CrossRef Katz MH, Wang H, Fleming JB, et al. Longterm survival after multidisciplinary management of resected pancreatic adenocarcinoma. Ann Surg Oncol. 2009;16:836–47.CrossRef
6.
go back to reference Jamieson NB, Foulis AK, Oien KA, et al. Positive mobilization margins alone do not influence survival following pancreaticoduodenectomy for pancreatic ductal adenocarcinoma. Ann Surg. 2010;251:1003–10.CrossRef Jamieson NB, Foulis AK, Oien KA, et al. Positive mobilization margins alone do not influence survival following pancreaticoduodenectomy for pancreatic ductal adenocarcinoma. Ann Surg. 2010;251:1003–10.CrossRef
7.
go back to reference Cleary SP, Gryfe R, Guindi M, et al. Prognostic factors in resected pancreatic adenocarcinoma: analysis of actual 5-year survivors. J Am Coll Surg. 2004;198:722–31.CrossRef Cleary SP, Gryfe R, Guindi M, et al. Prognostic factors in resected pancreatic adenocarcinoma: analysis of actual 5-year survivors. J Am Coll Surg. 2004;198:722–31.CrossRef
8.
go back to reference Zhu D, Wang L, Zhang H, et al. Prognostic value of 18F-FDG-PET/CT parameters in patients with pancreatic carcinoma: a systematic review and meta-analysis. Medicine (Baltimore). 2017;96(33):e7813.CrossRef Zhu D, Wang L, Zhang H, et al. Prognostic value of 18F-FDG-PET/CT parameters in patients with pancreatic carcinoma: a systematic review and meta-analysis. Medicine (Baltimore). 2017;96(33):e7813.CrossRef
9.
go back to reference Vriens D, Visser EP, de Geus-Oei LF, et al. Methodological considerations in quantification of oncological FDG PET studies. Eur J Nucl Med Mol Imaging. 2010;37:1408–25.CrossRef Vriens D, Visser EP, de Geus-Oei LF, et al. Methodological considerations in quantification of oncological FDG PET studies. Eur J Nucl Med Mol Imaging. 2010;37:1408–25.CrossRef
10.
go back to reference Dholakia AS, Chaudhry M, Leal JP, et al. Baseline metabolic tumor volume and total lesion glycolysis are associated with survival outcomes in patients with locally advanced pancreatic cancer receiving stereotactic body radiation therapy. Int J Radiat Oncol Biol Phys. 2014;89:539–46.CrossRef Dholakia AS, Chaudhry M, Leal JP, et al. Baseline metabolic tumor volume and total lesion glycolysis are associated with survival outcomes in patients with locally advanced pancreatic cancer receiving stereotactic body radiation therapy. Int J Radiat Oncol Biol Phys. 2014;89:539–46.CrossRef
11.
go back to reference Smith RA, Bosonnet L, Ghaneh P, et al. Preoperative CA19-9 levels and lymph node ratio are independent predictors of survival in patients with resected pancreatic ductal adenocarcinoma. Dig Surg. 2008;25(3):226–32.CrossRef Smith RA, Bosonnet L, Ghaneh P, et al. Preoperative CA19-9 levels and lymph node ratio are independent predictors of survival in patients with resected pancreatic ductal adenocarcinoma. Dig Surg. 2008;25(3):226–32.CrossRef
12.
go back to reference Safi F, Schlosser W, Falkenreck S, et al. Prognostic value of CA19-9 serum course in pancreatic cancer. Hepatogastroenterology. 1998;45:253–9.PubMed Safi F, Schlosser W, Falkenreck S, et al. Prognostic value of CA19-9 serum course in pancreatic cancer. Hepatogastroenterology. 1998;45:253–9.PubMed
13.
go back to reference Ferrone CR, Finkelstein DM, Thayer SP, et al. Perioperative CA19-9 levels can predict stage and survival in patients with pancreatic ductal adenocarcinoma. J Clin Oncol. 2006;24:2897–902.CrossRef Ferrone CR, Finkelstein DM, Thayer SP, et al. Perioperative CA19-9 levels can predict stage and survival in patients with pancreatic ductal adenocarcinoma. J Clin Oncol. 2006;24:2897–902.CrossRef
14.
go back to reference Chun YS, Pawlik TM, Vauthey JN. 8th edition of the AJCC Cancer staging manual: pancreas and hepatobiliary cancers. Ann Surg Oncol. 2018;25(4):845–7.CrossRef Chun YS, Pawlik TM, Vauthey JN. 8th edition of the AJCC Cancer staging manual: pancreas and hepatobiliary cancers. Ann Surg Oncol. 2018;25(4):845–7.CrossRef
15.
go back to reference Ell PJ. PET/CT in oncology: a major technology for cancer. Chang Gung Med J. 2005;28:274–83.PubMed Ell PJ. PET/CT in oncology: a major technology for cancer. Chang Gung Med J. 2005;28:274–83.PubMed
16.
go back to reference von Schulthess GK, Steinert HC, Hany TF. Integrated PET/CT: current applications and future directions. Radiology. 2006;238:405–22.CrossRef von Schulthess GK, Steinert HC, Hany TF. Integrated PET/CT: current applications and future directions. Radiology. 2006;238:405–22.CrossRef
17.
go back to reference Grassetto G, Rubello D. Role of FDG-PET/CT in diagnosis, staging, response to treatment, and prognosis of pancreatic cancer. Am J Clin Oncol. 2011;34:111–4.PubMed Grassetto G, Rubello D. Role of FDG-PET/CT in diagnosis, staging, response to treatment, and prognosis of pancreatic cancer. Am J Clin Oncol. 2011;34:111–4.PubMed
18.
go back to reference De Gaetano AM, Rufini V, Castaldi P, et al. Clinical applications of (18) F-FDG PET in the management of hepatobiliary and pancreatic tumors. Abdom Imaging. 2012;37:983–1003.CrossRef De Gaetano AM, Rufini V, Castaldi P, et al. Clinical applications of (18) F-FDG PET in the management of hepatobiliary and pancreatic tumors. Abdom Imaging. 2012;37:983–1003.CrossRef
19.
go back to reference Im HJ, Oo S. JungW, et al. prognostic value of metabolic and volumetric parameters of preoperative FDG-PET/CT in patients with resectable pancreatic cancer. Medicine. 2016;95:e3686.CrossRef Im HJ, Oo S. JungW, et al. prognostic value of metabolic and volumetric parameters of preoperative FDG-PET/CT in patients with resectable pancreatic cancer. Medicine. 2016;95:e3686.CrossRef
20.
go back to reference Lee JW, Kang CM, Choi HJ, et al. Prognostic value of metabolic tumor volume and total lesion glycolysis on preoperative (1)(8) F-FDG PET/CT in patients with pancreatic cancer. J Nucl Med. 2014;55:898–904.CrossRef Lee JW, Kang CM, Choi HJ, et al. Prognostic value of metabolic tumor volume and total lesion glycolysis on preoperative (1)(8) F-FDG PET/CT in patients with pancreatic cancer. J Nucl Med. 2014;55:898–904.CrossRef
21.
go back to reference Xu HX, Chen T, Wang WQ, et al. Metabolic tumour burden assessed by 18F-FDG PET/CT associated with serum CA19-9 predicts pancreatic cancer outcome after resection. Eur J Nucl Med Mol Imaging. 2014;41:1093–102.CrossRef Xu HX, Chen T, Wang WQ, et al. Metabolic tumour burden assessed by 18F-FDG PET/CT associated with serum CA19-9 predicts pancreatic cancer outcome after resection. Eur J Nucl Med Mol Imaging. 2014;41:1093–102.CrossRef
22.
go back to reference Wang Z, Chen JQ, Liu JL, et al. FDG-PET in diagnosis, staging and prognosis of pancreatic carcinoma: a meta-analysis. World J Gastroenterol. 2013;19:4808–17.CrossRef Wang Z, Chen JQ, Liu JL, et al. FDG-PET in diagnosis, staging and prognosis of pancreatic carcinoma: a meta-analysis. World J Gastroenterol. 2013;19:4808–17.CrossRef
23.
go back to reference Ballehaninna UK, Chamberlain RS. The clinical utility of serum CA 19-9 in the diagnosis, prognosis and management of pancreaticadenocarcinoma: an evidence based appraisal. J Gastrointest Oncol. 2012;3(2):105–19.PubMedPubMedCentral Ballehaninna UK, Chamberlain RS. The clinical utility of serum CA 19-9 in the diagnosis, prognosis and management of pancreaticadenocarcinoma: an evidence based appraisal. J Gastrointest Oncol. 2012;3(2):105–19.PubMedPubMedCentral
24.
go back to reference Bogoevski D, Yekebas EF, Schurr P, et al. Mode of spread in the early phase of lymphatic metasis in pancreatic ductal adenocarcinoma: prognostic significance of nodal microinvolvement. Ann Surg. 2004;240:993–1000.CrossRef Bogoevski D, Yekebas EF, Schurr P, et al. Mode of spread in the early phase of lymphatic metasis in pancreatic ductal adenocarcinoma: prognostic significance of nodal microinvolvement. Ann Surg. 2004;240:993–1000.CrossRef
Metadata
Title
Preoperative maximum standardized uptake value and carbohydrate antigen 19–9 were independent predictors of pathological stages and overall survival in Chinese patients with pancreatic duct adenocarcinoma
Authors
Xinjin Gu
Ruiquan Zhou
Chenggang Li
Rong Liu
Zhiming Zhao
Yuanxing Gao
Yong Xu
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2019
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-019-5691-4

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