دورية أكاديمية
أعرض في EDS

Metabolic tumor burden as a prognostic indicator after neoadjuvant chemotherapy in pancreatic cancer.

التفاصيل البيبلوغرافية
العنوان: Metabolic tumor burden as a prognostic indicator after neoadjuvant chemotherapy in pancreatic cancer.
المؤلفون: Lee W; Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine., Oh M; Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine., Kim JS; Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine., Sung M; Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine., Hong K; Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine., Kwak BJ; Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine., Park Y; Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine., Jun E; Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine., Song KB; Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine., Hwang DW; Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine., Lee JH; Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine., Yoo C; Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine., Kim KP; Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine., Park I; Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine., Jeong JH; Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine., Chang HM; Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine., Ryoo BY; Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine., Lee JB; Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine., Kim SC; Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Brain Korea 21 Project, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
المصدر: International journal of surgery (London, England) [Int J Surg] 2024 Jul 01; Vol. 110 (7), pp. 4074-4082. Date of Electronic Publication: 2024 Jul 01.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Wolters Kluwer Health, Inc Country of Publication: United States NLM ID: 101228232 Publication Model: Electronic Cited Medium: Internet ISSN: 1743-9159 (Electronic) Linking ISSN: 17439159 NLM ISO Abbreviation: Int J Surg Subsets: MEDLINE
أسماء مطبوعة: Publication: 2023- : [Philadelphia] : Wolters Kluwer Health, Inc.
Original Publication: London : Surgical Associates Ltd., c2004-
مواضيع طبية MeSH: Pancreatic Neoplasms*/drug therapy , Pancreatic Neoplasms*/pathology , Pancreatic Neoplasms*/mortality , Neoadjuvant Therapy* , Tumor Burden*/drug effects , Positron Emission Tomography Computed Tomography* , Antineoplastic Combined Chemotherapy Protocols*/therapeutic use, Humans ; Male ; Female ; Middle Aged ; Aged ; Prognosis ; Retrospective Studies ; Fluorodeoxyglucose F18 ; CA-19-9 Antigen/blood ; CA-19-9 Antigen/metabolism ; Fluorouracil/administration & dosage ; Adult ; Oxaliplatin/administration & dosage ; Oxaliplatin/therapeutic use ; Leucovorin/administration & dosage ; Leucovorin/therapeutic use ; Irinotecan
مستخلص: Background: There is no standardized assessment for evaluating response although neoadjuvant chemotherapy (NAT) is widely accepted for borderline resectable or locally advanced pancreatic cancer (BRPC or LAPC). This study was aimed to evaluate NAT response using positron emission tomography (PET) with 2-deoxy-2-[fluorine-18]fluoro-D-glucose ( 18 F-FDG-PET/CT) parameters alongside carbohydrate antigen (CA) 19-9 levels.
Methods: Patients who underwent surgery after NAT for BRPC and LAPC between 2017 and 2021 were identified. The study assessed the prognostic value of PET-derived parameters after NAT, determining cutoff values using the K-adaptive partitioning method. It created four groups based on the elevation or normalization of PET parameters and CA19-9 levels, comparing survival between these groups.
Results: Of 200 eligible patients, FOLFIRINOX and gemcitabine-based NAT was administered in 166 and 34 patients, respectively (mean NAT cycles, 8.3). In a multivariate analysis, metabolic tumor volume (MTV) demonstrated the most robust performance in assessing response [hazard ratio (HR) 3.11, 95% confidence interval (CI) 1.73-5.58, P <0.001] based on cutoff value of 2.4. Patients with decreased MTV had significantly better survival than those with elevated MTV among individuals with CA19-9 levels less than 37 IU/l (median survival; 35.5 vs. 20.9 months, P <0.001) and CA19-9 levels at least 37 IU/l (median survival; 34.3 vs. 17.8 months, P =0.03). In patients suspected to be Lewis antigen negative, the predictive performance of MTV was found to be limited ( P =0.84).
Conclusion: Elevated MTV is an influential prognostic factor for worse survival, regardless of post-NAT CA19-9 levels. These results could be helpful in identifying patients with a poor prognosis despite normalization of CA19-9 levels after NAT.
(Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)
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المشرفين على المادة: 0Z5B2CJX4D (Fluorodeoxyglucose F18)
0 (CA-19-9 Antigen)
0 (folfirinox)
U3P01618RT (Fluorouracil)
04ZR38536J (Oxaliplatin)
Q573I9DVLP (Leucovorin)
7673326042 (Irinotecan)
تواريخ الأحداث: Date Created: 20240327 Date Completed: 20240723 Latest Revision: 20240723
رمز التحديث: 20240723
مُعرف محوري في PubMed: PMC11254192
DOI: 10.1097/JS9.0000000000001389
PMID: 38537071
قاعدة البيانات: MEDLINE
الوصف
تدمد:1743-9159
DOI:10.1097/JS9.0000000000001389