Prognostic significance of baseline 18F-FDG PET/CT metabolic quantitative parameters for ampullary adenocarcinoma patients.

BACKGROUND: Preoperative prognosis prediction is of significance for ampullary cancer patients. The prognostic factors of ampullary adenocarcinoma have been rarely studied, particularly the PET/CT metabolic parameters. This study aimed to investigate the prognostic significance of quantitative metabolic parameters on baseline 18F-FDG PET/CT scans in patients with ampullary adenocarcinoma. METHODS: The clinical characteristics, histopathological features, and quantitative PET/CT parameters of ampullary adenocarcinoma patients were analyzed. Cox proportional hazard regression analyses were performed to identify independent predictors for tumor progression or patient survival. Progression free survival (PFS) and overall survival (OS) were evaluated using the Kaplan-Meier curves, and survival differences were compared using the log-rank test. RESULTS: This retrospective study enrolled fifty-two ampullary adenocarcinoma patients (28 men, 24 women) with a median age of 64 years. The 1-year, 2-year, and 5-year PFS were 69.2%, 61.5%, and 59.6%, while OS were 90.4%, 78.8%, and 76.9%, respectively. Multivariate regression analyses revealed that the PET/CT volumetric parameter total lesion glycolysis (TLG) [hazard ratio (HR): 9.306, p < 0.001] and histologic differentiation grade (HR:3.477, p = 0.007) of the primary tumor lesion were predictive factors for PFS. Besides, TLG (HR:9.033, p = 0.046) and tumor size (HR:6.977, p = 0.018) were significant variables for predicting the OS. CONCLUSIONS: The present study demonstrated that the PET volumetric parameter TLG of the primary tumor lesion emerged as a potential prognostic biomarker for PFS (together with histologic differentiation) and for overall survival (together with tumor size) of patients with ampullary adenocarcinoma.