Standardized uptake value on positron emission tomography/computed tomography predicts prognosis in patients with locally advanced pancreatic cancer

The aim of the present study was to investigate the use and value of maximum standardized uptake value (SUVmax) on positron emission tomography/computed tomography (PET/CT) images as a prognostic marker for patients with locally advanced pancreatic cancer (LAPC). The medical records of all consecutive patients who underwent PET/CT examination in our institution were retrospectively reviewed. Inclusion criteria were histologically or cytologically proven LAPC. Patients with distant metastasis were excluded. For statistical analysis, the SUVmax of primary pancreatic cancer was measured. Survival rates were calculated using the Kaplan-Meier method, and multivariable analysis was performed to determine the association of SUVmax with overall survival (OS) and progression-free survival (PFS) using a Cox proportional hazards model. Between July 2006 and June 2013, 69 patients were enrolled in the present study. OS and PFS were 14.9 months [95% confidence interval (CI) 13.1-16.7] and 8.3 months (95% CI 7.1-9.5), respectively. A high SUVmax (> 5.5) was observed in 35 patients, who had significantly worse OS and PFS than the remaining patients with a low SUVmax (P = 0.025 and P = 0.003). Univariate analysis showed that SUVmax and tumor size were prognostic factors for OS, with a hazard ratio of 1.90 and 1.81, respectively. A high SUVmax was an independent prognostic factor, with a hazard ratio of 1.89 (95% CI 1.015-3.519, P = 0.045). The present study suggests that increased SUVmax is a predictor of poor prognosis in patients with LAPC.