Recurrence-free long-term survival after liver transplantation in patients with 18F-FDG non-avid hilar cholangiocarcinoma on PET.
The aim of this retrospective study was to assess the value of (18)F-fluorodeoxyglucose positron emission tomography ((18)F-FDG-PET) for predicting biological tumor behavior and outcome after liver transplantation (LT) in patients with otherwise unresectable hilar cholangiocarcinoma (HC). Preoperative (18)F-FDG-PET scanning was performed in 13 patients with type IV Klatskin tumor before LT. PET+ status indicated patients with an increased pretransplant (18)F-FDG uptake, whereas PET- recipients had no increased preoperative (18)F-FDG uptake on PET. Pretransplant PET findings were correlated with histopathological tumor characteristics and patient outcome after LT. Eight patients demonstrated positive preoperative PET findings (61.5%), whereas five patients had no increased preoperative (18)F-FDG tumor uptake (38.5%) on PET. One PET+ patient died after 1 month due to liver allograft dysfunction. Seven PET+ liver recipients developed tumor recurrence, whereas five PET- patients were tumor-free alive after a median of 76 months post-LT (p = 0.001). The 2-year recurrence-free survival rate after LT was 100% in PET- patients and 28.6% in the PET+ population (log-rank = 0.008). Our results suggest that patients with (18)F-FDG non-avid HC on PET may achieve recurrence-free long-term survival after LT.
Department of General, Visceral and Vascular Surgery, Jena, Germany. Arno.Kornberg@med.uni-jena.de
A
A
Kornberg
B
B
Küpper
K
K
Thrum
J
J
Wilberg
A
A
Sappler
D
D
Gottschild
D000328:Adult; D000368:Aged; D001650:Bile Duct Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery; D001653:Bile Ducts, Intrahepatic; D018281:Cholangiocarcinoma / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery; D018572:Disease-Free Survival; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D016031:Liver Transplantation / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality; D049268:Positron-Emission Tomography / Q000379:methods*; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate
D019788:Fluorodeoxyglucose F18