Abstract
BACKGROUND: Retrospective analysis to investigate the relationship between the flow-metabolic phenotype and overall survival (OS) of pancreatic ductal adenocarcinoma (PDAC) and its potential clinical utility.
METHODS: Patients with histopathologically proven PDAC between 2005 and 2014 using tumor attenuation on routine pre-operative CECT as a surrogate for the vascularity and [ 18F]FDG-uptake as a surrogate for metabolic activity on [ 18F]FDG-PET.
RESULTS: In total, 93 patients (50 male, 43 female, median age 63) were included. Hypoattenuating PDAC with high [ 18F]FDG-uptake has the poorest prognosis (median OS 7 ± 1 months), compared to hypoattenuating PDAC with low [ 18F]FDG-uptake (median OS 11 ± 3 months; p = 0.176), iso- or hyperattenuating PDAC with high [ 18F]FDG-uptake (median OS 15 ± 5 months; p = 0.004) and iso- or hyperattenuating PDAC with low [ 18F]FDG-uptake (median OS 23 ± 4 months; p = 0.035). In multivariate analysis, surgery combined with tumor differentiation, tumor stage, systemic therapy and flow metabolic phenotype remained independent predictors for overall survival.
DISCUSSION: The novel qualitative flow-metabolic phenotype of PDAC using a combination of CECT and [ 18F]FDG-PET features, predicted significantly worse survival for hypoattenuating-high uptake pancreatic cancers compared to the other phenotypes.
| Original language | English |
|---|---|
| Pages (from-to) | 389-399 |
| Number of pages | 11 |
| Journal | International Hepato-Pancreato Biliary Association. |
| Volume | 26 |
| Issue number | 3 |
| Early online date | 25 Nov 2023 |
| DOIs | |
| Publication status | Published - Mar 2024 |