Prognostic value of (18)F-fluorodeoxyglucose positron emission tomography in patients with extrahepatic bile duct cancer.
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.
Kitamura
Koji
K
Department of Surgery, Graduate School of Medicine Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan.
Hatano
Etsuro
E
Higashi
Tatsuya
T
Seo
Satoru
S
Nakamoto
Yuji
Y
Narita
Masato
M
Taura
Kojiro
K
Yasuchika
Kentaro
K
Nitta
Takashi
T
Yamanaka
Kenya
K
Doi
Ryuichiro
R
Ikai
Iwao
I
Uemoto
Shinji
S
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
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18