Evaluación del papel de la sarcopenia y de los parámetros de la PET/TC con [18F]FDG en el pronóstico del adenocarcinoma ductal de páncreas

IF 1.6 4区医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Revista Espanola De Medicina Nuclear E Imagen Molecular Pub Date : 2024-11-01 DOI:10.1016/j.remn.2024.500046

H. Önner, M.N. Calderon Tobar, L. Perktaş, F. Yilmaz, G. Kara Gedik

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引用次数: 0

Abstract

This study investigates the relationship between ¹⁸F-fluorodeoxyglucose ([¹⁸F]FDG) positron emission tomography/computed tomography (PET/CT) metabolic parameters, clinicopathological characteristics, and sarcopenia in patients with pancreatic ductal adenocarcinoma (PDAC) and evaluates their prognostic roles.

Material and methods

The primary tumor's maximum standard uptake (SUVmax), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) values, as well as clinicopathological factors, were evaluated retrospectively. Computed tomography (CT) was used to assess the skeletal muscle index (SMI). Sarcopenia was defined based on SMI calculated at the third lumbar vertebra (L3). SMI cut-off values for sarcopenia were accepted as 44.77 cm²/m² for men and 32.50 cm²/m² for women. The primary endpoint was the overall survival (OS). OS data were analyzed by the Kaplan-Meier method and compared using the log-rank test. To identify predictive factors for sarcopenia, multivariable logistic regression was used following univariable logistic regression. Cox proportional hazards regression analyses were used to find predictors of OS.

Results

Of the 86 patients included in the study, 37 (43%) were diagnosed with sarcopenia. Compared with non-sarcopenic patients, sarcopenia was observed in older patients (P = .028) and patients with lower body mass index (BMI) (P = .001). Age and BMI independently predicted sarcopenia. Univariate analysis identified sarcopenia, advanced stage, and higher primary tumor TLG as significant predictors of overall survival. Multivariate Cox regression analysis revealed that the advanced tumor stage (P = .017) and higher TLG (P = .042) independently predicted OS. The median OS was 9.4 months in non-sarcopenic patients and 5.0 months in sarcopenic patients (P = .021).

Conclusion

In this study cohort, advanced-stage disease and higher primary tumor TLG were identified as independent predictors of OS in patients with PDAC. Additionally, we emphasize the importance of incorporating [¹⁸F]FDG PET/CT-derived sarcopenia assessments into the prognostic evaluation and clinical management of PDAC patients. While sarcopenia was associated with shorter OS in univariate analysis, it was not an independent predictor in multivariate analysis.

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评估肌肉疏松症和 [18F]FDG PET/CT 参数在胰腺导管腺癌预后中的作用。

本研究探讨了胰腺导管腺癌（PDAC）患者的18F-氟脱氧葡萄糖（[18F]FDG）正电子发射断层扫描/计算机断层扫描（PET/CT）代谢参数、临床病理特征和肌肉疏松症之间的关系，并评估其预后作用。材料与方法对原发肿瘤的最大标准摄取量（SUVmax）、代谢肿瘤体积（MTV）和总病变糖酵解（TLG）值以及临床病理因素进行了回顾性评估。计算机断层扫描（CT）用于评估骨骼肌指数（SMI）。根据第三腰椎（L3）计算的 SMI 值来定义肌肉疏松症。肌肉疏松症的 SMI 临界值男性为 44.77 cm2/m2，女性为 32.50 cm2/m2。主要终点是总生存期（OS）。OS 数据采用 Kaplan-Meier 法进行分析，并使用对数秩检验进行比较。为了确定肌肉疏松症的预测因素，在单变量逻辑回归之后采用了多变量逻辑回归。结果在纳入研究的86名患者中，有37人（43%）被确诊为肌肉疏松症。与非肌肉疏松症患者相比，年龄较大的患者（P = .028）和体重指数（BMI）较低的患者（P = .001）会出现肌肉疏松症。年龄和体重指数可独立预测肌肉疏松症。单变量分析发现，肌肉疏松症、晚期和原发肿瘤 TLG 较高是总生存率的重要预测因素。多变量 Cox 回归分析显示，肿瘤晚期（P = .017）和原发肿瘤 TLG 较高（P = .042）可独立预测 OS。结论在本研究队列中，晚期疾病和原发肿瘤TLG较高被认为是PDAC患者OS的独立预测因素。此外，我们还强调了将[18F]FDG PET/CT 衍生的肌肉疏松症评估纳入 PDAC 患者预后评估和临床管理的重要性。在单变量分析中，肌肉疏松症与较短的OS相关，但在多变量分析中，它并不是一个独立的预测因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Revista Espanola De Medicina Nuclear E Imagen Molecular RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-

CiteScore

1.10

自引率

16.70%

发文量

审稿时长

24 days

期刊介绍： The Revista Española de Medicina Nuclear e Imagen Molecular (Spanish Journal of Nuclear Medicine and Molecular Imaging), was founded in 1982, and is the official journal of the Spanish Society of Nuclear Medicine and Molecular Imaging, which has more than 700 members. The Journal, which publishes 6 regular issues per year, has the promotion of research and continuing education in all fields of Nuclear Medicine as its main aim. For this, its principal sections are Originals, Clinical Notes, Images of Interest, and Special Collaboration articles.