711P - Does FDG-PET-CT based Re-Staging Influences Initial Management Decision and Clinical Outcome in Patients with locally advanced Pancreatic Carcinoma Planned to Undergo Chemoradiotherapy?

Abstract

ABSTRACT Background Impact of re-staging with 18F-fluoro-deoxy-glucose positron emission tomography (PET-CT) on management decision and clinical outcomes in patients with locally-advanced pancreatic carcinoma (LAPC) initially planned to undergo concurrent chemoradiotherapy (CRT) was investigated. Materials and methods Seventy-one consecutive patients with conventionally staged LAPC were re-staged with PET-CT before CRT. Patients were categorized into non-metastatic (M0) and metastatic (M1) groups according to PET-CT findings. M0patients underwent 50.4 Gy (1.8 Gy/fr) of radiotherapy and concurrent 5-FU followed by maintenance gemcitabine. Results Re-staging PET-CT revealed conventional imaging occult distant metastases in 19 cases (26.8%). Of 52 patients with LAPC confirmed by PET-CT, additional regional lymph nodes were identified to be involved in 7 (13.4%), mandating enlargement of radiation field. Taken together, PET-CT results changed or revised initial management decision in 37.2% patients. Median follow-up times for the whole, M0 and M1 cohorts were 11.3, 14.5, and 6.2 months, respectively. Median overall, locoregional progression-free, and progression-free survivals for the same cohorts were 11.4, 7.8, and 5.1 months,16.1, 9.9, and 7.4 months, and 6.2, 3.4, and 2.5 months, respectively. Survival differences between M0 and M1 cohorts were statistically significant (p Conclusions Current results demonstrated the importance of PET-CT based re-staging of LAPC in selection of suitable patients for CRT, prevention of useless aggressive treatment in metastatic cases, and precise estimation of survival outcomes of LAPC patients following radical CRT. Disclosure All authors have declared no conflicts of interest.