Purpose: To evaluate the predictive value of18F-FDG PET/CT semiquantitative parameters of the primary tumour and CA 19-9 levels assessed before treatment in patients with locally advanced pancreatic cancer (LAPC). Methods: Among one-hundred twenty patients with LAPC treated at our institution with initial chemotherapy followed by curative chemoradiotherapy (CRT) from July 2013 to January 2019, a secondary analysis with baseline18F-FDG PET/CT was conducted in fifty-eight patients. Pre-treatment CA 19-9 level and the maximum standardized uptake value (SUVmax), metabolic tumour volume (MTV) and total lesion glycolysis (TLG) of primary tumour were measured. The receiving operating characteristics (ROC) analysis was performed to define the cut-off point of SUVmax, MTV, TLG and CA 19-9 values to use in prediction of early progression (EP), local progression (LP) and overall survival (OS). Areas under the curve (AUCs) were assessed for all variables. Post-test probability was calculated to evaluate the advantage for parameters combination. Results: For EP, CA 19-9 level > 698 U/mL resulted the best marker to identify patient at higher risk with OR of 5.96 (95% CI, 1.66–19.47; p = 0.005) and a Positive Predictive Value (PPV) of 61%. For LP, the most significant parameter was TLG (OR 9.75, 95% CI, 1.64–57.87, p = 0.012), with PPV of 83%. For OS, the most significant parameter was MTV (OR 3.12, 95% CI, 0.9–10.83, p = 0.07) with PPV of 88%. Adding consecutively each of the other parameters, PPV to identify patients at risk resulted further increased (>90%). Conclusions: Pre-treatment CA 19-9 level, as well as MTV and TLG values of primary tumour at baseline18F-FDG PET/CT and their combination, may represent significant predictors of EP, LP and OS in LAPC patients.

Fiore, M., Taralli, S., Trecca, P., Scolozzi, V., Marinelli, L., Triumbari, E. K. A., Caputo, D., Angeletti, S., Ciccozzi, M., Coppola, A., Greco, C., Ippolito, E., Calcagni, M. L., Coppola, R., Ramella, S., A bio-imaging signature as a predictor of clinical outcomes in locally advanced pancreatic cancer, <<CANCERS>>, 2020; 12 (8): 1-10. [doi:10.3390/cancers12082016] [http://hdl.handle.net/10807/177070]

A bio-imaging signature as a predictor of clinical outcomes in locally advanced pancreatic cancer

Taralli S.;Triumbari E. K. A.;Calcagni M. L.;
2020

Abstract

Purpose: To evaluate the predictive value of18F-FDG PET/CT semiquantitative parameters of the primary tumour and CA 19-9 levels assessed before treatment in patients with locally advanced pancreatic cancer (LAPC). Methods: Among one-hundred twenty patients with LAPC treated at our institution with initial chemotherapy followed by curative chemoradiotherapy (CRT) from July 2013 to January 2019, a secondary analysis with baseline18F-FDG PET/CT was conducted in fifty-eight patients. Pre-treatment CA 19-9 level and the maximum standardized uptake value (SUVmax), metabolic tumour volume (MTV) and total lesion glycolysis (TLG) of primary tumour were measured. The receiving operating characteristics (ROC) analysis was performed to define the cut-off point of SUVmax, MTV, TLG and CA 19-9 values to use in prediction of early progression (EP), local progression (LP) and overall survival (OS). Areas under the curve (AUCs) were assessed for all variables. Post-test probability was calculated to evaluate the advantage for parameters combination. Results: For EP, CA 19-9 level > 698 U/mL resulted the best marker to identify patient at higher risk with OR of 5.96 (95% CI, 1.66–19.47; p = 0.005) and a Positive Predictive Value (PPV) of 61%. For LP, the most significant parameter was TLG (OR 9.75, 95% CI, 1.64–57.87, p = 0.012), with PPV of 83%. For OS, the most significant parameter was MTV (OR 3.12, 95% CI, 0.9–10.83, p = 0.07) with PPV of 88%. Adding consecutively each of the other parameters, PPV to identify patients at risk resulted further increased (>90%). Conclusions: Pre-treatment CA 19-9 level, as well as MTV and TLG values of primary tumour at baseline18F-FDG PET/CT and their combination, may represent significant predictors of EP, LP and OS in LAPC patients.
eng
Fiore, M., Taralli, S., Trecca, P., Scolozzi, V., Marinelli, L., Triumbari, E. K. A., Caputo, D., Angeletti, S., Ciccozzi, M., Coppola, A., Greco, C., Ippolito, E., Calcagni, M. L., Coppola, R., Ramella, S., A bio-imaging signature as a predictor of clinical outcomes in locally advanced pancreatic cancer, <>, 2020; 12 (8): 1-10. [doi:10.3390/cancers12082016] [http://hdl.handle.net/10807/177070]
File in questo prodotto:
File Dimensione Formato  
FIORE_2020.pdf

accesso aperto

Tipologia file ?: Versione Editoriale (PDF)
Licenza: Creative commons
Dimensione 838.14 kB
Formato Adobe PDF
838.14 kB Adobe PDF Visualizza/Apri

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/10807/177070
Citazioni
  • ???jsp.display-item.citation.pmc??? 1
  • Scopus 1
  • ???jsp.display-item.citation.isi??? 1
social impact