Preoperative volume-based PET parameter, MTV 2.5 , as a potential surrogate marker for tumor biology and recurrence in resected pancreatic cancer

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

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

This study aims to evaluate the role of volume-based positron emission tomography parameters as potential surrogate markers for tumor recurrence in resected pancreatic cancer. Between January 2008 and October 2012, medical records of patients who underwent surgical resection for pancreatic ductal adenocarcinoma and completed 18 18 -fluorodeoxyglucose positron emission tomography/CT as a part of preoperative staging work-up were retrospectively reviewed. Not only clinicopathologic variables but also positron emission tomography parameters such as SUVmax, MTV 2.5 (metabolic tumor volume), and TLG (total lesion glycolysis) were obtained. Twenty-six patientswerewomen and 31were men with a mean age of 62.9-9.1 years. All patients were preoperatively determined to resectable pancreatic cancer except 1 case with borderline resectability. R0 resection was achieved in all patients and 45 patients (78.9%) received postoperative adjuvant chemotherapy with or without radiation therapy. Median overall disease-free survival was 12.8 months with a median overall disease-specific survival of 25.1 months. SUVmax did not correlate with radiologic tumor size (P=0.501); however,MTV 2.5 (P=0.001) and TLG(P=0.009)were significantly associatedwith radiologic tumor size. In addition, MTV 2.5 (P<0.001) and TLG (P<0.001) were significantly correlated with a tumor differentiation. There were no significant differences in TLG and SUVmax according to lymph node ratio; only MTV 2.5 was related to lymph node ratiowithmarginal significance (P=0.055). In multivariate analysis, lymph node ratio (Exp [b]=2.425, P=0.025) and MTV 2.5 (Exp[b]=2.273, P=0.034) were identified as independent predictors of tumor recurrence followingmargin-negative resection. Even after tumor size-matched analysis, MTV 2.5 was still identified as significant prognostic factor in resected pancreatic cancer (P<0.05). However, preoperative neoadjuvant treatment attenuated adverse oncologic impact of high preoperative MTV 2.5 (P=0.210). Preoperatively determined volume-based PET parameter, MTV 2.5 , can potentially be used as a surrogate marker to estimate tumor biology and tumor recurrence. Individual treatment strategies for pancreatic cancer can be suggested based on patients' preoperative MTV 2.5 .

Original languageEnglish
Article numbere2595
JournalMedicine (United States)
Volume95
Issue number9
DOIs
Publication statusPublished - 2016 Mar 4

Fingerprint

Pancreatic Neoplasms
Biomarkers
Recurrence
Glycolysis
Neoplasms
Positron-Emission Tomography
Lymph Nodes
Neoadjuvant Therapy
Adjuvant Chemotherapy
Tumor Burden
Disease-Free Survival
Medical Records
Adenocarcinoma
Radiotherapy
Multivariate Analysis
Survival

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

@article{19fa69b1f3194caa8d9b6cdc967cd322,
title = "Preoperative volume-based PET parameter, MTV 2.5 , as a potential surrogate marker for tumor biology and recurrence in resected pancreatic cancer",
abstract = "This study aims to evaluate the role of volume-based positron emission tomography parameters as potential surrogate markers for tumor recurrence in resected pancreatic cancer. Between January 2008 and October 2012, medical records of patients who underwent surgical resection for pancreatic ductal adenocarcinoma and completed 18 18 -fluorodeoxyglucose positron emission tomography/CT as a part of preoperative staging work-up were retrospectively reviewed. Not only clinicopathologic variables but also positron emission tomography parameters such as SUVmax, MTV 2.5 (metabolic tumor volume), and TLG (total lesion glycolysis) were obtained. Twenty-six patientswerewomen and 31were men with a mean age of 62.9-9.1 years. All patients were preoperatively determined to resectable pancreatic cancer except 1 case with borderline resectability. R0 resection was achieved in all patients and 45 patients (78.9{\%}) received postoperative adjuvant chemotherapy with or without radiation therapy. Median overall disease-free survival was 12.8 months with a median overall disease-specific survival of 25.1 months. SUVmax did not correlate with radiologic tumor size (P=0.501); however,MTV 2.5 (P=0.001) and TLG(P=0.009)were significantly associatedwith radiologic tumor size. In addition, MTV 2.5 (P<0.001) and TLG (P<0.001) were significantly correlated with a tumor differentiation. There were no significant differences in TLG and SUVmax according to lymph node ratio; only MTV 2.5 was related to lymph node ratiowithmarginal significance (P=0.055). In multivariate analysis, lymph node ratio (Exp [b]=2.425, P=0.025) and MTV 2.5 (Exp[b]=2.273, P=0.034) were identified as independent predictors of tumor recurrence followingmargin-negative resection. Even after tumor size-matched analysis, MTV 2.5 was still identified as significant prognostic factor in resected pancreatic cancer (P<0.05). However, preoperative neoadjuvant treatment attenuated adverse oncologic impact of high preoperative MTV 2.5 (P=0.210). Preoperatively determined volume-based PET parameter, MTV 2.5 , can potentially be used as a surrogate marker to estimate tumor biology and tumor recurrence. Individual treatment strategies for pancreatic cancer can be suggested based on patients' preoperative MTV 2.5 .",
author = "ChangMoo Kang and Lee, {Sung Hwan} and Hwang, {Ho Kyoung} and Mijin Yun and Lee, {Woo Jung}",
year = "2016",
month = "3",
day = "4",
doi = "10.1097/MD.0000000000002595",
language = "English",
volume = "95",
journal = "Medicine (United States)",
issn = "0025-7974",
publisher = "Lippincott Williams and Wilkins",
number = "9",

}

Preoperative volume-based PET parameter, MTV 2.5 , as a potential surrogate marker for tumor biology and recurrence in resected pancreatic cancer . / Kang, ChangMoo; Lee, Sung Hwan; Hwang, Ho Kyoung; Yun, Mijin; Lee, Woo Jung.

In: Medicine (United States), Vol. 95, No. 9, e2595, 04.03.2016.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Preoperative volume-based PET parameter, MTV 2.5 , as a potential surrogate marker for tumor biology and recurrence in resected pancreatic cancer

AU - Kang, ChangMoo

AU - Lee, Sung Hwan

AU - Hwang, Ho Kyoung

AU - Yun, Mijin

AU - Lee, Woo Jung

PY - 2016/3/4

Y1 - 2016/3/4

N2 - This study aims to evaluate the role of volume-based positron emission tomography parameters as potential surrogate markers for tumor recurrence in resected pancreatic cancer. Between January 2008 and October 2012, medical records of patients who underwent surgical resection for pancreatic ductal adenocarcinoma and completed 18 18 -fluorodeoxyglucose positron emission tomography/CT as a part of preoperative staging work-up were retrospectively reviewed. Not only clinicopathologic variables but also positron emission tomography parameters such as SUVmax, MTV 2.5 (metabolic tumor volume), and TLG (total lesion glycolysis) were obtained. Twenty-six patientswerewomen and 31were men with a mean age of 62.9-9.1 years. All patients were preoperatively determined to resectable pancreatic cancer except 1 case with borderline resectability. R0 resection was achieved in all patients and 45 patients (78.9%) received postoperative adjuvant chemotherapy with or without radiation therapy. Median overall disease-free survival was 12.8 months with a median overall disease-specific survival of 25.1 months. SUVmax did not correlate with radiologic tumor size (P=0.501); however,MTV 2.5 (P=0.001) and TLG(P=0.009)were significantly associatedwith radiologic tumor size. In addition, MTV 2.5 (P<0.001) and TLG (P<0.001) were significantly correlated with a tumor differentiation. There were no significant differences in TLG and SUVmax according to lymph node ratio; only MTV 2.5 was related to lymph node ratiowithmarginal significance (P=0.055). In multivariate analysis, lymph node ratio (Exp [b]=2.425, P=0.025) and MTV 2.5 (Exp[b]=2.273, P=0.034) were identified as independent predictors of tumor recurrence followingmargin-negative resection. Even after tumor size-matched analysis, MTV 2.5 was still identified as significant prognostic factor in resected pancreatic cancer (P<0.05). However, preoperative neoadjuvant treatment attenuated adverse oncologic impact of high preoperative MTV 2.5 (P=0.210). Preoperatively determined volume-based PET parameter, MTV 2.5 , can potentially be used as a surrogate marker to estimate tumor biology and tumor recurrence. Individual treatment strategies for pancreatic cancer can be suggested based on patients' preoperative MTV 2.5 .

AB - This study aims to evaluate the role of volume-based positron emission tomography parameters as potential surrogate markers for tumor recurrence in resected pancreatic cancer. Between January 2008 and October 2012, medical records of patients who underwent surgical resection for pancreatic ductal adenocarcinoma and completed 18 18 -fluorodeoxyglucose positron emission tomography/CT as a part of preoperative staging work-up were retrospectively reviewed. Not only clinicopathologic variables but also positron emission tomography parameters such as SUVmax, MTV 2.5 (metabolic tumor volume), and TLG (total lesion glycolysis) were obtained. Twenty-six patientswerewomen and 31were men with a mean age of 62.9-9.1 years. All patients were preoperatively determined to resectable pancreatic cancer except 1 case with borderline resectability. R0 resection was achieved in all patients and 45 patients (78.9%) received postoperative adjuvant chemotherapy with or without radiation therapy. Median overall disease-free survival was 12.8 months with a median overall disease-specific survival of 25.1 months. SUVmax did not correlate with radiologic tumor size (P=0.501); however,MTV 2.5 (P=0.001) and TLG(P=0.009)were significantly associatedwith radiologic tumor size. In addition, MTV 2.5 (P<0.001) and TLG (P<0.001) were significantly correlated with a tumor differentiation. There were no significant differences in TLG and SUVmax according to lymph node ratio; only MTV 2.5 was related to lymph node ratiowithmarginal significance (P=0.055). In multivariate analysis, lymph node ratio (Exp [b]=2.425, P=0.025) and MTV 2.5 (Exp[b]=2.273, P=0.034) were identified as independent predictors of tumor recurrence followingmargin-negative resection. Even after tumor size-matched analysis, MTV 2.5 was still identified as significant prognostic factor in resected pancreatic cancer (P<0.05). However, preoperative neoadjuvant treatment attenuated adverse oncologic impact of high preoperative MTV 2.5 (P=0.210). Preoperatively determined volume-based PET parameter, MTV 2.5 , can potentially be used as a surrogate marker to estimate tumor biology and tumor recurrence. Individual treatment strategies for pancreatic cancer can be suggested based on patients' preoperative MTV 2.5 .

UR - http://www.scopus.com/inward/record.url?scp=84962622775&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84962622775&partnerID=8YFLogxK

U2 - 10.1097/MD.0000000000002595

DO - 10.1097/MD.0000000000002595

M3 - Article

VL - 95

JO - Medicine (United States)

JF - Medicine (United States)

SN - 0025-7974

IS - 9

M1 - e2595

ER -