Preoperative metabolic tumor volume2.5 associated with early systemic metastasis in resected pancreatic cancer: A transcriptome-wide analysis

Sung Hwan Lee, Ho Kyoung Hwang, Woo Jung Lee, Mijin Yun, Chang Moo Kang

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background/Aims: 18F-fluorodeoxyglucose-positron emission tomography (18F-FDG-PET) reflects biological aggressiveness and predicts prognoses in various tumors. Evaluating the oncologic significance of the preoperative metabolic phenotype might be necessary for planning the surgical strategy in resectable pancreatic cancers. Methods: From January 2010 to December 2015, a total of 93 patients with pathologic T3 (pT3) pancreatic cancer were included in this study. Clinicopathological parameters and PET parameters were evaluated, and transcriptome-wide analysis was performed to identify the oncologic impact and molecular landscape of the metabolic phenotype of resectable pancreatic cancers. Results: Preoperative metabolic tumor volume (MTV)2.5was significantly higher in the pN1 group compared to the pN0 group (11.1±11.2 vs 6.5±7.8, p=0.031). Higher MTV2.5values (MTV2.5≥4.5) were associated with multiple lymph node metastasis (p=0.003), and the lymph node ratio was also significantly higher in resected pT3 pancreatic cancer with MTV2.5≥4.5 compared to those with MTV2.5 <4.5 (0.12±0.13 vs 0.05±0.08, p=0.001). Disease-specific survival of patients with MTV2.5<4.5 was better than that of patients with MTV2.5≥4.5 (mean, 28.8 months; 95% confidence interval [CI], 40.1 to 57.0 vs mean, 32.6 months; 95% CI, 25.5 to 39.7; p=0.026). Patients with MTV2.5≥4.5 who received postoperative adjuvant chemotherapy showed better survival outcomes than patients with MTV2.5≥4.5 who did not receive adjuvant treatment in resected pT3 pancreatic cancers (p<0.001). Transcriptome-wide analysis revealed that tumors with MTV2.5≥4.5 demonstrated significantly different expression of cancer-related genes reflecting aggressive tumor biology. Conclusions: Resectable pancreatic cancer with high MTV2.5is not only associated with lymph node metastasis but also early systemic metastasis. The molecular background of resectable pancreatic cancer with high MTV2.5may be associated with aggressive biologic behavior, which might need to be considered when managing resectable pancreatic cancers. Further study is mandatory.

Original languageEnglish
Pages (from-to)356-365
Number of pages10
JournalGut and liver
Volume13
Issue number3
DOIs
Publication statusPublished - 2019 Jan 1

Fingerprint

Gene Expression Profiling
Pancreatic Neoplasms
Neoplasm Metastasis
Neoplasms
Lymph Nodes
Confidence Intervals
Phenotype
Survival
Neoplasm Genes
Fluorodeoxyglucose F18
Adjuvant Chemotherapy
Tumor Burden
Positron-Emission Tomography

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Gastroenterology

Cite this

@article{9fb75f420e1646cf820e9a3741d093b2,
title = "Preoperative metabolic tumor volume2.5 associated with early systemic metastasis in resected pancreatic cancer: A transcriptome-wide analysis",
abstract = "Background/Aims: 18F-fluorodeoxyglucose-positron emission tomography (18F-FDG-PET) reflects biological aggressiveness and predicts prognoses in various tumors. Evaluating the oncologic significance of the preoperative metabolic phenotype might be necessary for planning the surgical strategy in resectable pancreatic cancers. Methods: From January 2010 to December 2015, a total of 93 patients with pathologic T3 (pT3) pancreatic cancer were included in this study. Clinicopathological parameters and PET parameters were evaluated, and transcriptome-wide analysis was performed to identify the oncologic impact and molecular landscape of the metabolic phenotype of resectable pancreatic cancers. Results: Preoperative metabolic tumor volume (MTV)2.5was significantly higher in the pN1 group compared to the pN0 group (11.1±11.2 vs 6.5±7.8, p=0.031). Higher MTV2.5values (MTV2.5≥4.5) were associated with multiple lymph node metastasis (p=0.003), and the lymph node ratio was also significantly higher in resected pT3 pancreatic cancer with MTV2.5≥4.5 compared to those with MTV2.5 <4.5 (0.12±0.13 vs 0.05±0.08, p=0.001). Disease-specific survival of patients with MTV2.5<4.5 was better than that of patients with MTV2.5≥4.5 (mean, 28.8 months; 95{\%} confidence interval [CI], 40.1 to 57.0 vs mean, 32.6 months; 95{\%} CI, 25.5 to 39.7; p=0.026). Patients with MTV2.5≥4.5 who received postoperative adjuvant chemotherapy showed better survival outcomes than patients with MTV2.5≥4.5 who did not receive adjuvant treatment in resected pT3 pancreatic cancers (p<0.001). Transcriptome-wide analysis revealed that tumors with MTV2.5≥4.5 demonstrated significantly different expression of cancer-related genes reflecting aggressive tumor biology. Conclusions: Resectable pancreatic cancer with high MTV2.5is not only associated with lymph node metastasis but also early systemic metastasis. The molecular background of resectable pancreatic cancer with high MTV2.5may be associated with aggressive biologic behavior, which might need to be considered when managing resectable pancreatic cancers. Further study is mandatory.",
author = "Lee, {Sung Hwan} and Hwang, {Ho Kyoung} and Lee, {Woo Jung} and Mijin Yun and Kang, {Chang Moo}",
year = "2019",
month = "1",
day = "1",
doi = "10.5009/gnl18242",
language = "English",
volume = "13",
pages = "356--365",
journal = "Gut and Liver",
issn = "1976-2283",
publisher = "Joe Bok Chung",
number = "3",

}

Preoperative metabolic tumor volume2.5 associated with early systemic metastasis in resected pancreatic cancer : A transcriptome-wide analysis. / Lee, Sung Hwan; Hwang, Ho Kyoung; Lee, Woo Jung; Yun, Mijin; Kang, Chang Moo.

In: Gut and liver, Vol. 13, No. 3, 01.01.2019, p. 356-365.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Preoperative metabolic tumor volume2.5 associated with early systemic metastasis in resected pancreatic cancer

T2 - A transcriptome-wide analysis

AU - Lee, Sung Hwan

AU - Hwang, Ho Kyoung

AU - Lee, Woo Jung

AU - Yun, Mijin

AU - Kang, Chang Moo

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background/Aims: 18F-fluorodeoxyglucose-positron emission tomography (18F-FDG-PET) reflects biological aggressiveness and predicts prognoses in various tumors. Evaluating the oncologic significance of the preoperative metabolic phenotype might be necessary for planning the surgical strategy in resectable pancreatic cancers. Methods: From January 2010 to December 2015, a total of 93 patients with pathologic T3 (pT3) pancreatic cancer were included in this study. Clinicopathological parameters and PET parameters were evaluated, and transcriptome-wide analysis was performed to identify the oncologic impact and molecular landscape of the metabolic phenotype of resectable pancreatic cancers. Results: Preoperative metabolic tumor volume (MTV)2.5was significantly higher in the pN1 group compared to the pN0 group (11.1±11.2 vs 6.5±7.8, p=0.031). Higher MTV2.5values (MTV2.5≥4.5) were associated with multiple lymph node metastasis (p=0.003), and the lymph node ratio was also significantly higher in resected pT3 pancreatic cancer with MTV2.5≥4.5 compared to those with MTV2.5 <4.5 (0.12±0.13 vs 0.05±0.08, p=0.001). Disease-specific survival of patients with MTV2.5<4.5 was better than that of patients with MTV2.5≥4.5 (mean, 28.8 months; 95% confidence interval [CI], 40.1 to 57.0 vs mean, 32.6 months; 95% CI, 25.5 to 39.7; p=0.026). Patients with MTV2.5≥4.5 who received postoperative adjuvant chemotherapy showed better survival outcomes than patients with MTV2.5≥4.5 who did not receive adjuvant treatment in resected pT3 pancreatic cancers (p<0.001). Transcriptome-wide analysis revealed that tumors with MTV2.5≥4.5 demonstrated significantly different expression of cancer-related genes reflecting aggressive tumor biology. Conclusions: Resectable pancreatic cancer with high MTV2.5is not only associated with lymph node metastasis but also early systemic metastasis. The molecular background of resectable pancreatic cancer with high MTV2.5may be associated with aggressive biologic behavior, which might need to be considered when managing resectable pancreatic cancers. Further study is mandatory.

AB - Background/Aims: 18F-fluorodeoxyglucose-positron emission tomography (18F-FDG-PET) reflects biological aggressiveness and predicts prognoses in various tumors. Evaluating the oncologic significance of the preoperative metabolic phenotype might be necessary for planning the surgical strategy in resectable pancreatic cancers. Methods: From January 2010 to December 2015, a total of 93 patients with pathologic T3 (pT3) pancreatic cancer were included in this study. Clinicopathological parameters and PET parameters were evaluated, and transcriptome-wide analysis was performed to identify the oncologic impact and molecular landscape of the metabolic phenotype of resectable pancreatic cancers. Results: Preoperative metabolic tumor volume (MTV)2.5was significantly higher in the pN1 group compared to the pN0 group (11.1±11.2 vs 6.5±7.8, p=0.031). Higher MTV2.5values (MTV2.5≥4.5) were associated with multiple lymph node metastasis (p=0.003), and the lymph node ratio was also significantly higher in resected pT3 pancreatic cancer with MTV2.5≥4.5 compared to those with MTV2.5 <4.5 (0.12±0.13 vs 0.05±0.08, p=0.001). Disease-specific survival of patients with MTV2.5<4.5 was better than that of patients with MTV2.5≥4.5 (mean, 28.8 months; 95% confidence interval [CI], 40.1 to 57.0 vs mean, 32.6 months; 95% CI, 25.5 to 39.7; p=0.026). Patients with MTV2.5≥4.5 who received postoperative adjuvant chemotherapy showed better survival outcomes than patients with MTV2.5≥4.5 who did not receive adjuvant treatment in resected pT3 pancreatic cancers (p<0.001). Transcriptome-wide analysis revealed that tumors with MTV2.5≥4.5 demonstrated significantly different expression of cancer-related genes reflecting aggressive tumor biology. Conclusions: Resectable pancreatic cancer with high MTV2.5is not only associated with lymph node metastasis but also early systemic metastasis. The molecular background of resectable pancreatic cancer with high MTV2.5may be associated with aggressive biologic behavior, which might need to be considered when managing resectable pancreatic cancers. Further study is mandatory.

UR - http://www.scopus.com/inward/record.url?scp=85066163748&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85066163748&partnerID=8YFLogxK

U2 - 10.5009/gnl18242

DO - 10.5009/gnl18242

M3 - Article

C2 - 30602217

AN - SCOPUS:85066163748

VL - 13

SP - 356

EP - 365

JO - Gut and Liver

JF - Gut and Liver

SN - 1976-2283

IS - 3

ER -