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Preoperative Metabolic Tumor Volume2.5 Associated with Early Systemic Metastasis in Resected Pancreatic Cancer: A Transcriptome-Wide Analysis

Authors
 Sung Hwan Lee  ;  Ho Kyoung Hwang  ;  Woo Jung Lee  ;  Mijin Yun  ;  Chang Moo Kang 
Citation
 GUT AND LIVER, Vol.13(3) : 356-365, 2019 
Journal Title
 GUT AND LIVER 
ISSN
 1976-2283 
Issue Date
2019
Keywords
Metabolic phenotype ; Pancreatic neoplasms ; Positron-emission tomography ; Transcriptome-wide analysis
Abstract
BACKGROUND/AIMS: 18F-fluorodeoxyglucose-positron emission tomography (18F-FDG-PET) reflects biological aggressiveness and predicts prognoses in various tumors. Evaluating the oncologic significance of the preoperative metabolic phenotype might be necessary for planning the surgical strategy in resectable pancreatic cancers. METHODS: From January 2010 to December 2015, a total of 93 patients with pathologic T3 (pT3) pancreatic cancer were included in this study. Clinicopathological parameters and PET parameters were evaluated, and transcriptome-wide analysis was performed to identify the oncologic impact and molecular landscape of the metabolic phenotype of resectable pancreatic cancers. RESULTS: Preoperative metabolic tumor volume (MTV)2.5 was significantly higher in the pN1 group compared to the pN0 group (11.1±11.2 vs 6.5±7.8, p=0.031). Higher MTV2.5 values (MTV2.5 ≥4.5) were associated with multiple lymph node metastasis (p=0.003), and the lymph node ratio was also significantly higher in resected pT3 pancreatic cancer with MTV2.5 ≥4.5 compared to those with MTV2.5 <4.5 (0.12±0.13vs 0.05±0.08, p=0.001). Disease-specific survival of patientswith MTV2.5 <4.5 was better than that of patients withMTV2.5 ≥4.5 (mean, 28.8 months; 95% confidence interval[CI], 40.1 to 57.0 vs mean, 32.6 months; 95% CI, 25.5 to 39.7; p=0.026). Patients with MTV2.5 ≥4.5 who received postoperative adjuvant chemotherapy showed better survival outcomes than patients with MTV2.5 ≥4.5 who did not receive adjuvant treatment in resected pT3 pancreatic cancers (p<0.001). Transcriptome-wide analysis revealed that tumors with MTV2.5 ≥4.5 demonstrated significantly different expression of cancer-related genes reflecting aggressive tumor biology. CONCLUSIONS: Resectable pancreatic cancer with high MTV2.5 is not only associated with lymph node metastasis but also early systemic metastasis. The molecular background of resectable pancreatic cancer with high MTV2.5 may be associated with aggressive biologic behavior, which might need to be considered when managing resectable pancreatic cancers. Further study is mandatory.
Files in This Item:
T201902222.pdf Download
DOI
10.5009/gnl18242
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Nuclear Medicine (핵의학교실) > 1. Journal Papers
Yonsei Authors
Kang, Chang Moo(강창무) ORCID logo https://orcid.org/0000-0002-5382-4658
Yun, Mi Jin(윤미진) ORCID logo https://orcid.org/0000-0002-1712-163X
Lee, Woo Jung(이우정) ORCID logo https://orcid.org/0000-0001-9273-261X
Hwang, Ho Kyoung(황호경) ORCID logo https://orcid.org/0000-0003-4064-7776
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/170401
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