Detailed Abstract
[BP Oral Presentation 2]
[BP OP 2-2] The role of positron emission tomography scan derived parameters in prediction of response after neoadjuvant chemotherapy for borderline resectable and locally advanced pancreatic cancer
Woohyung LEE, Yejong PARK, Jae Woo KWON, Ki Byung SONG, Jae Hoon LEE, Dae Wook HWANG, Song Cheol KIM*
Division of Hepatobiliary and Pancreatic Surgery, Asan Medical Center, Korea
Introduction : Although neoadjuvant chemotherapy (NACT) became the main stream of management for borderline resectable (BRPC) or locally advanced pancreatic cancer (LAPC), adequate biologic markers for response after NACT was not confirmed yet.
Methods : BRPC and LAPC patients with positive emission tomographic (PET) scan in both pre-NACT and post-NACT were included between 2012 and 2019. The risk factors for tumor regression grade (TRG), and worse prognosis were evaluated including PET derived parameters.
Results : Of 189 patients, R1 resection (hazard ratio [HR]; 2.711, 95% confidence interval [CI]; 1.280-5.740, p = 0.009) was the prognostic factor for worse survival and vessel resection (HR; 2.196, 95% CI; 1.363 – 3.538, p = 0.001), adjacent organ resection (HR; 2.764, 95% CI; 1.233 – 6.196, p = 0.014), increased carbohydrate antigen (CA) 19-9 value (HR; 1.783, 95% CI; 1.138 – 2.792, p = 0.012) of after NACT were prognostic factors for faster recurrence. And 54 patients with PET data were evaluated. Marked response of TRG was related with relative difference of standardized uptake value (SUV) max and SUV peak (HR; 0.019, 95% CI; 0 - 0.423, p = 0.028). Prognostic factors were found such as total lesion glycolysis (TLG) (HR; 1.670, 95% CI; 1.102 – 2.531, p = 0.016), metabolic tumor volume (MTV) (HR; 1.716, 95% CI; 1.102 – 2.673, p = 0.017) in post-NACT state and relative difference during NACT as well as chemo cycle (HR; 0.762, 95% CI; 0.605 – 0.961, p =0.028).
Conclusions : The changing parameters of PET are helpful to evaluate response after after NACT.
Methods : BRPC and LAPC patients with positive emission tomographic (PET) scan in both pre-NACT and post-NACT were included between 2012 and 2019. The risk factors for tumor regression grade (TRG), and worse prognosis were evaluated including PET derived parameters.
Results : Of 189 patients, R1 resection (hazard ratio [HR]; 2.711, 95% confidence interval [CI]; 1.280-5.740, p = 0.009) was the prognostic factor for worse survival and vessel resection (HR; 2.196, 95% CI; 1.363 – 3.538, p = 0.001), adjacent organ resection (HR; 2.764, 95% CI; 1.233 – 6.196, p = 0.014), increased carbohydrate antigen (CA) 19-9 value (HR; 1.783, 95% CI; 1.138 – 2.792, p = 0.012) of after NACT were prognostic factors for faster recurrence. And 54 patients with PET data were evaluated. Marked response of TRG was related with relative difference of standardized uptake value (SUV) max and SUV peak (HR; 0.019, 95% CI; 0 - 0.423, p = 0.028). Prognostic factors were found such as total lesion glycolysis (TLG) (HR; 1.670, 95% CI; 1.102 – 2.531, p = 0.016), metabolic tumor volume (MTV) (HR; 1.716, 95% CI; 1.102 – 2.673, p = 0.017) in post-NACT state and relative difference during NACT as well as chemo cycle (HR; 0.762, 95% CI; 0.605 – 0.961, p =0.028).
Conclusions : The changing parameters of PET are helpful to evaluate response after after NACT.
SESSION
BP Oral Presentation 2
Room B 7/27/2020 2:10 PM - 2:20 PM