Does tumour SUVmax predict adverse prognostic features in patients with pancreatic cancer?

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Introduction: Pancreatic ductal adenocarcinoma (PDAC) is a fatal disease with poor long term outcomes. The majority of indicators associated with early recurrence and poor survival are obtained post-operatively which limit their clinical utility. The aim of this study was to investigate whether tumour SUVmax obtained on 18FDG PET/CT is associated with adverse prognostic indicators in patients with PDAC. Methods: We identified patients diagnosed with PDAC from a clinical trial database investigating the role of 18FDG PET/CT in patients with suspected pancreatic cancer (PETPANC trial-ISRCTN73852054). Single variable linear and logistic regression models were fitted to examine the association of tumour SUVmax with: tumour size, differentiation, baseline CA 19.9, presence of lymph nodes and distant metastasis using Wilcoxon and Pearson χ2 tests in addition to fisher's exact test. Results: 257 patients with PDAC were identified from the trial registry. The Pearson's correlation test showed no association between tumour size (n = 249) and CA 19.9 (n = 163) with tumour SUVmax (r = 0.138 and 0.024 respectively). Single variable logistic regression analysis showed that tumour SUVmax had a statistically significant effect on the presence of distant metastasis [OR 1.07 (95% CI 1.00–1.15); p = 0.044)] but not for the presence of positive lymph nodes (p = 0.472). Single variable linear regression showed that the degree of histological differentiation did not have an impact on tumour SUVmax (p = 0.596). Conclusions: Pancreatic tumour SUVmax is associated with the presence of distant metastasis but was not associated with lymph node positivity nor the degree of histological differentiation.