Cancer Research and Treatment

Original Articles

Gastrointestinal cancer

Risk Stratification of Pancreatic Ductal Adenocarcinoma Patients Undergoing Curative-Intent Surgery after Neoadjuvant Therapy: Hyun Kyung Yang, Mi-Suk Park, Kyunghwa Han, Geonsik Eom, Yong Eun Chung, Jin-Young Choi, Seungmin Bang, Chang Moo Kang, Jinsil Seong, Myeong-Jin Kim; Cancer Res Treat. 2024;56(1):247-258. Published online August 22, 2023; DOI: https://doi.org/10.4143/crt.2023.586

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Purpose
Clinical prognostic criteria using preoperative factors were not developed for post–neoadjuvant therapy (NAT) surgery of pancreatic ductal adenocarcinoma (PDAC). We aimed to identify preoperative factors associated with overall survival (OS) in PDAC patients who underwent post-NAT curative-intent surgery and develop risk stratification criteria.
Materials and Methods
Consecutive PDAC patients who underwent post-NAT curative-intent surgeries between 2007 and 2020 were retrospectively analyzed. Demographic, laboratory, surgical, and histopathologic variables were collected. Baseline, preoperative, and interval changes of computed tomography (CT) findings proposed by the Society of Abdominal Radiology and the American Pancreatic Association were analyzed. Cox proportional hazard analysis was used to select preoperative variables associated with OS. We developed risk stratification criteria composed of the significant preoperative variables, i.e., post-NAT response criteria. We compared the discrimination performance of post-NAT response criteria with that of post-NAT pathological (yp) American Joint Cancer Committee TNM staging system.
Results
One hundred forty-five PDAC patients were included. Stable or increased tumor size on CT (hazard ratio [HR], 2.58; 95% confidence interval [CI], 1.58 to 4.21; p < 0.001) and elevated preoperative carbohydrate antigen 19-9 (CA19-9) level (HR, 1.98; 95% CI, 1.11 to 3.55; p=0.021) were independent factors of OS. The OS of the patient groups stratified by post-NAT response criteria which combined changes in tumor size and CA19-9 showed significant difference (p < 0.001). Such stratification was comparable to ypTNM staging in discrimination performance (difference of C-index, 0.068; 95% CI, –0.012 to 0.142).
Conclusion
“Any degree of decrease in tumor size on CT” and CA19-9 normalization or staying normal were independent favorable factors of OS. The combination of the two factors discriminated OS comparably to ypTNM staging.

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Prognostic factors in localized pancreatic ductal adenocarcinoma after neoadjuvant therapy and resection: a systematic review and meta-analysis
Ammar A Javed, Alyssar Habib, Omar Mahmud, Asad Saulat Fatimi, Mahip Grewal, Nabiha Mughal, Jin He, Christopher L Wolfgang, Lois Daamen, Marc G Besselink
JNCI: Journal of the National Cancer Institute.2025; 117(5): 840. CrossRef

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Detecting Metastatic Bladder Cancer Using ¹⁸F-Fluorodeoxyglucose Positron-Emission Tomography/Computed Tomography: Hakan Öztürk; Cancer Res Treat. 2015;47(4):834-843. Published online February 12, 2015; DOI: https://doi.org/10.4143/crt.2014.157

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Purpose
The purpose of this study was to retrospectively investigate the contribution of 18F-fluorodeoxyglucose- positron emission tomography/computed tomography (18F-FDG-PET/CT) to detection of metastatic bladder cancer. Materials and Methods The present study included 79 patients (69 men and 10 women) undergoing 18F-FDGPET/ CT upon suspicion of metastatic bladder cancer between July 2007 and April 2013. The mean age was 66.1 years with a standard deviation of 10.7 years (range, 21 to 85 years). Patients were required to fast for 6 hours prior to scanning, and whole-body PET scanning from the skull base to the upper thighs was performed approximately 1 hour after intravenous injection of 555 MBq of 18F-FDG. Whole body CT scanning was performed in the cranio-caudal direction. FDG-PET images were reconstructed using CT data for attenuation correction. Suspicious recurrent or metastatic lesions were confirmed by histopathology or clinical follow-up. Results The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 18F-FDG-PET/CT were 89%, 78%, 90%, 75%, and 86%, respectively. Conclusion 18F-FDG-PET/CT can detect metastases with high sensitivity and positive predictive values in patients with metastatic bladder carcinoma.

Citations

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Maximizing Outcomes with Chemoimmunotherapy in Lymph Node–only Metastatic Urothelial Cancer: Targeting a Favorable Subgroup
Charles B. Nguyen, Wesley Yip
European Urology.2025;[Epub] CrossRef
Radiotherapy in metastatic bladder cancer
Sophie Ashley, Ananya Choudhury, Peter Hoskin, YeePei Song, Priyamvada Maitre
World Journal of Urology.2024;[Epub] CrossRef
PET Imaging in Bladder Cancer: An Update and Future Direction
Jules Zhang-Yin, Antoine Girard, Etienne Marchal, Thierry Lebret, Marie Homo Seban, Marine Uhl, Marc Bertaux
Pharmaceuticals.2023; 16(4): 606. CrossRef
Accuracy of FDG-PET/CT for Response Evaluation of Muscle-Invasive Bladder Cancer following Neoadjuvant or Induction Chemotherapy
Olivier Fitoussi, Jean Baptiste Roche, Julien Riviere, Hervé Wallerand, Jean Eude Poulain, Pierre Gordien, Sigolène Galland, Bénédicte Henriques, Camille Dupin, Muriel Vincent, Thomas Kuratle, Mo Saffarini, Sonia Ramos-Pascual
Urologia Internationalis.2023; 107(3): 239. CrossRef
PET/CT in Bladder Cancer: An Update
Kirsten Bouchelouche
Seminars in Nuclear Medicine.2022; 52(4): 475. CrossRef
Quantitative positron emission tomography imaging in the presence of iodinated contrast media using electron density quantifications from dual‐energy computed tomography
Nadav Shapira, Joshua Scheuermann, Amy E. Perkins, Johoon Kim, Leening P Liu, Joel S. Karp, Peter B. Noël
Medical Physics.2021; 48(1): 273. CrossRef
18F-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography in muscle-invasive bladder cancer
Sarah M.H. Einerhand, Erik J. van Gennep, Laura S. Mertens, Kees Hendricksen, Maarten L. Donswijk, Henk G. van der Poel, Bas W.G. van Rhijn
Current Opinion in Urology.2020; 30(5): 654. CrossRef
The Role of 18F-FDG PET/CT in Guiding Precision Medicine for Invasive Bladder Carcinoma
Antoine Girard, Helena Vila Reyes, Hiram Shaish, Jean-François Grellier, Laurent Dercle, Pierre-Yves Salaün, Olivier Delcroix, Mathieu Rouanne
Frontiers in Oncology.2020;[Epub] CrossRef
Cancers de la vessie
A. Girard, J.F. Grellier, P.Y. Salaün
Médecine Nucléaire.2019; 43(1): 69. CrossRef
Comment on: Relationship between the expression of PD-1/PD-L1 and 18F-FDG uptake in bladder cancer
Antoine Girard, Mathieu Rouanne
European Journal of Nuclear Medicine and Molecular Imaging.2019; 46(6): 1212. CrossRef
Comparison between the diagnostic accuracies of 18F-fluorodeoxyglucose positron emission tomography/computed tomography and conventional imaging in recurrent urothelial carcinomas: a retrospective, multicenter study
Fabio Zattoni, Elena Incerti, Michele Colicchia, Paolo Castellucci, Stefano Panareo, Maria Picchio, Federico Fallanca, Alberto Briganti, Marco Moschini, Andrea Gallina, Jeffrey R. Karnes, Val Lowe, Stefano Fanti, Riccardo Schiavina, Ilaria Rambaldi, Vince
Abdominal Radiology.2018; 43(9): 2391. CrossRef
The role of PET/CT in the evaluation of patients with urothelial cancer: a systematic review and meta-analysis
Anna Rita Cervino, Lea Cuppari, Pasquale Reccia, Marta Burei, Giorgio Saladini, Laura Evangelista
Clinical and Translational Imaging.2018; 6(2): 77. CrossRef
Pelvic Lymph Node Staging by Combined 18 F-FDG-PET/CT Imaging in Bladder Cancer Prior to Radical Cystectomy
Renate Pichler, Tobias De Zordo, Josef Fritz, Alexander Kroiss, Friedrich Aigner, Isabel Heidegger, Irene Virgolini, Wolfgang Horninger, Christian Uprimny
Clinical Genitourinary Cancer.2017; 15(3): e387. CrossRef
Metabolic coupling in urothelial bladder cancer compartments and its correlation to tumor aggressiveness
Julieta Afonso, Lúcio L. Santos, António Morais, Teresina Amaro, Adhemar Longatto-Filho, Fátima Baltazar
Cell Cycle.2016; 15(3): 368. CrossRef
The importance of clinical stage among patients with a complete pathologic response at radical cystectomy after neoadjuvant chemotherapy
William P. Parker, Philip L. Ho, Stephen A. Boorjian, Jonathan J. Melquist, Prabin Thapa, Jeffrey M. Holzbeierlein, Igor Frank, Ashish M. Kamat, Eugene K. Lee
World Journal of Urology.2016; 34(11): 1561. CrossRef

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