title: Prognostic value of (18)F-fluorodeoxyglucose positron emission tomography in patients with extrahepatic bile duct cancer.
abstract: BACKGROUND
  (18)F-fluorodeoxyglucose positron emission tomography (FDG-PET) is used in the differential diagnosis and staging of extrahepatic bile duct cancer (EBDC), but its prognostic value has not been fully elucidated. In this study, we investigated the prognostic value of FDG-PET in EBDC patients.
  
  
  METHODS
  The study included 73 consecutive patients with EBDC, of whom 48 underwent surgical resection for EBDC. The effects of clinicopathological factors including the standardized uptake value (SUV) of the primary lesion and lymph node metastasis detected by FDG-PET (PET-N) on overall survival were evaluated.
  
  
  RESULTS
  In all 73 patients, multivariate analysis showed that surgical resection (risk ratio 2.5, 95% confidence interval [CI] 1.17-5.35, P = 0.018) and the SUV (2.0, 1.07-3.91, P = 0.030) were independent predictors of survival. In the 48 patients who underwent surgical resection, multivariate analysis revealed that perineural invasion (risk ratio 3.2, 95% CI 1.28-7.93, P = 0.012), pathologic lymph node metastasis (3.4, 1.27-9.17, P = 0.015), and PET-N (4.0, 1.10-15.25, P = 0.036) were independent predictors of overall survival. In the 25 patients without surgical resection, the SUV showed a significant relationship with overall survival (P = 0.014).
  
  
  CONCLUSIONS
  Our data suggest that the SUV of the primary lesion is a useful prognostic factor in patients with EBDC, and the prognosis for patients with PET-N remains very poor despite surgical resection.
authors.affiliation: Department of Surgery, Graduate School of Medicine Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Kitamura
authors.forename: Etsuro
authors.initials: E
authors.lastname: Hatano
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Higashi
authors.forename: Satoru
authors.initials: S
authors.lastname: Seo
authors.forename: Yuji
authors.initials: Y
authors.lastname: Nakamoto
authors.forename: Masato
authors.initials: M
authors.lastname: Narita
authors.forename: Kojiro
authors.initials: K
authors.lastname: Taura
authors.forename: Kentaro
authors.initials: K
authors.lastname: Yasuchika
authors.forename: Takashi
authors.initials: T
authors.lastname: Nitta
authors.forename: Kenya
authors.initials: K
authors.lastname: Yamanaka
authors.forename: Ryuichiro
authors.initials: R
authors.lastname: Doi
authors.forename: Iwao
authors.initials: I
authors.lastname: Ikai
authors.forename: Shinji
authors.initials: S
authors.lastname: Uemoto
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D017734:Bile Ducts, Extrahepatic / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography / Q000379:methods*; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity; D015996:Survival Rate
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18