İnoperabl Pankreas Duktal Adenokarsinomunda Genel Sağ Kalım Öngörücülerinin Değerlendirilmesi

Year 2022, Volume: 32 Issue: 1, 1 - 4, 28.02.2022

Mustafa Erol , Hasan Önner , İlknur Küçükosmanoğlu

https://doi.org/10.54005/geneltip.972458

Cited By: 2

Abstract

Amaç: Çalışmamızda, inoperabl pankreas duktal adenokarsinomlu (PDAK) hastaların genel sağ kalımının (GSK) bağımsız öngörücü parametreleri araştırılacaktır. Bulunan parametreler, PDAK hastaları için hassas tıp uygulamalarını şekillendirmede potansiyel biyobelirteç olarak kullanılabilecektir.
Materyal ve metot: Ocak 2016 - Aralık 2019 tarihleri arasında inoperabl pankreas duktal adenokarsinom tanısı alan ve bölümümüzde 18-florodeoksiglukoz pozitron emisyon tomografisi/bilgisayarlı tomografi (18F-FDG PET/BT) tetkiki yapılan hastaların klinik ve patolojik verileri retrospektif olarak incelendi. 18F-FDG PET/BT görüntülerinden tümörün çapı, maksimumu standardize tutulum değeri (STDmaks), metabolik tümör volümü (MTV) ve toplam lezyon glikolizisi (TLG) hesaplandı. GSK üzerine etki eden değişkenlerin araştırılması için tek değişkenli ve çok değişkenli Cox regresyon analizleri yapıldı. GSK verileri Kaplan–Meier yöntemiyle, log-rank testi kullanılarak incelendi.
Bulgular: Çalışmaya ortalama yaşı 65.85 ± 1.64 olan 31’i erkek 17’si kadın toplam 48 hasta dahil edildi. GSK üzerine etki eden faktörleri incelemek için yapılan tek değişkenli Cox regresyon analizlerinde p değeri:< 0.2 olan klinikopatolojik faktörler (tümör lokalizasyonu, tümör çapı, evre) ve 18F-FDG PET/BT parametrelerinin (STDmaks, MTV ve TLG) çok değişkenli Cox regresyon analizine dahil edilmesi sonucu TLG’nin, GSK’ın tek bağımsız öngürücüsü olduğu bulundu. Yapılan Kaplan-Meier analizinde, TLG’nin median değerinin 298.34’ün üzerinde olan hastaların ortanca GSK süresi 13.87 ay iken, TLG değeri bu değerin altında olan hastalarda ortanca GSK süresi 4.97 ay olarak bulundu.
Sonuç: Çalışmamızda, tümörün hem metabolik aktivitesini hem de hacmini birlikte yansıtan, 18F-FDG PET/BT parametresi olan TLG değeri, PDAK hastalarının GSK’ının tek bağımsız öngörücüsü olarak bulundu. TLG, inoperabl PDAK'lı hastalarda sağkalım için potansiyel bir biyobelirteç olarak kullanılabilir ve hassas tıp uygulamalarına yardımcı olabilir.

Keywords

F-18 florodeoksiglukoz pozitron emisyon tomografisi/bilgisayarlı tomografi, Toplam lezyon glikolizisi, Pankreas duktal adenokarsinomu

Evaluation of Overall Survival Predictions In Inoperable Pancreas Ductal Adenocarcinoma

Abstract

Objective: In this study, we aimed to determine the independent predictive parameters of overall survival (OS) of
patients with inoperable pancreatic ductal adenocarcinoma (PDAC) and to investigate whether these parameters
can be used as potential biomarkers to shape precision medicine practices for PDAC patients.
Material and Methods: The clinical and pathological data of patients who were diagnosed with inoperable
pancreatic ductal adenocarcinoma between January 2016 and December 2019 and who underwent
18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) in our department
were retrospectively analyzed. Tumor diameter, maximum standardized uptake value (SUVmax), metabolic
tumor volume (MTV), and total lesion glycolysis (TLG) were calculated from FDG PET/CT images. Univariate and
multivariate Cox regression analyzes were performed to investigate the variable affecting overall survival. Overall
survival data were analyzed using the Kaplan–Meier method, using the log-rank test.
Results: A total of 48 patients, 31 male and 17 female, with a mean age of 65.85 ± 1.64 were included in the study.
In univariate Cox regression analyzes were performed to examine the factor affecting OS. Clinicopathological
factors (tumor localization, tumor diameter, stage) and FDG PET/CT parameters (SUVmax, MTV and TLG) with a
p-value of < 0.2 were compared to multivariate Cox regression analysis. TLG was found to be the only independent
predictor of OS. In the Kaplan-Meier analysis, the median OS duration of the patients with a median value of TLG
below 298.34 was 13.87 months, while the median OS duration was found to be 4.97 months in patients with a TLG
value above this value.
Conclusion: In our study, TLG value, which is an FDG PET/CT parameter that reflects both the metabolic activity and
the volume of the tumor, was found to be the only independent predictor of the OS of inoperable PDAC patients.
TLG can be used as a potential biomarker for survival in patients with inoperable PDAC and may assist precision
medicine applications.

Keywords

Pancreatic ductal adenocarcinoma, fluorodeoxyglucose, Positron emission tomography / computed tomography, total lesion glycolysis

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