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Itchins, Malinda; Chua, Terence C.; Arena, Jennifer; Jamieson, Nigel B.; Nahm, Christopher B.; O'Connell, Rachel L.; Bailey, Elizabeth A.; Schembri, Geoffrey P.; Gill, Anthony J.; Kneebone, Andrew; Hruby, George; Mittal, Anubhav; Pavlakis, Nick; Clarke, Stephen J.; Samra, Jaswinder S.

Evaluation of Fluorodeoxyglucose Positron Emission Tomography Scanning in the Neoadjuvant Therapy Paradigm in Pancreatic Ductal Adenocarcinoma

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  • Media type: E-Article
  • Title: Evaluation of Fluorodeoxyglucose Positron Emission Tomography Scanning in the Neoadjuvant Therapy Paradigm in Pancreatic Ductal Adenocarcinoma
  • Contributor: Itchins, Malinda; Chua, Terence C.; Arena, Jennifer; Jamieson, Nigel B.; Nahm, Christopher B.; O'Connell, Rachel L.; Bailey, Elizabeth A.; Schembri, Geoffrey P.; Gill, Anthony J.; Kneebone, Andrew; Hruby, George; Mittal, Anubhav; Pavlakis, Nick; Clarke, Stephen J.; Samra, Jaswinder S.
  • imprint: Ovid Technologies (Wolters Kluwer Health), 2020
  • Published in: Pancreas
  • Language: English
  • DOI: 10.1097/mpa.0000000000001472
  • ISSN: 1536-4828; 0885-3177
  • Origination:
  • Footnote:
  • Description: <jats:sec> <jats:title>Objectives</jats:title> <jats:p>Little data exist on the utility of fluorodeoxyglucose positron emission tomography (FDG-PET) in operable pancreatic ductal adenocarcinoma (PDAC) treated with neoadjuvant (NA) therapy.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>Consecutively treated patients with potentially operable PDAC were recruited from a quaternary referral center between 2015 and 2018. Data were collated on demographic, clinical, radiological, treatment, and disease-free and overall survival (OS) outcome measures, correlated with FDG-PET findings.</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>Of 115 patients recruited, 61% were deemed upfront operable (n = 70), 33% borderline (n = 38), and 6% (n = 7) locally advanced. Ninety-five (83%) received NA chemotherapy with 23 (24%) sequential radiotherapy. Sixty-nine (73%) treated with NA were resected, 37 (54%) attained an R0 resection, 43 (62%) had N1 disease with median tumor viability of 50%. The median OS in the entire cohort was 30.48 months and in those who received NA chemotherapy followed by resection 37.98 months. Twelve percent (n = 13) were upstaged during NA therapy by PET. Preoperative standardized uptake value maximum of less than 5 versus 5 or greater after NA predicted for improved OS, 42.95 months versus 26.05 months, <jats:italic toggle="yes">P</jats:italic> = 0.02.</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions</jats:title> <jats:p>In this real-world cohort study of PDAC, the utility of FDG-PET in informing the patient treatment pathway was meaningfully demonstrated.</jats:p> </jats:sec>