Frontiers in Oncology (May 2021)
A Novel Validated Recurrence Stratification System Based on 18F-FDG PET/CT Radiomics to Guide Surveillance After Resection of Pancreatic Cancer
- Miaoyan Wei,
- Miaoyan Wei,
- Miaoyan Wei,
- Miaoyan Wei,
- Miaoyan Wei,
- Bingxin Gu,
- Bingxin Gu,
- Bingxin Gu,
- Shaoli Song,
- Shaoli Song,
- Shaoli Song,
- Bo Zhang,
- Bo Zhang,
- Bo Zhang,
- Bo Zhang,
- Bo Zhang,
- Wei Wang,
- Wei Wang,
- Wei Wang,
- Wei Wang,
- Wei Wang,
- Jin Xu,
- Jin Xu,
- Jin Xu,
- Jin Xu,
- Jin Xu,
- Xianjun Yu,
- Xianjun Yu,
- Xianjun Yu,
- Xianjun Yu,
- Xianjun Yu,
- Si Shi,
- Si Shi,
- Si Shi,
- Si Shi,
- Si Shi
Affiliations
- Miaoyan Wei
- Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China
- Miaoyan Wei
- Pancreatic Cancer Multidisciplinary Center, Fudan University Shanghai Cancer Center, Shanghai, China
- Miaoyan Wei
- Department of Oncology, Fudan University Shanghai Medical College, Shanghai, China
- Miaoyan Wei
- Pancreatic Cancer Institute, Fudan University, Shanghai, China
- Miaoyan Wei
- Shanghai Pancreatic Cancer Institute, Shanghai, China
- Bingxin Gu
- Department of Oncology, Fudan University Shanghai Medical College, Shanghai, China
- Bingxin Gu
- Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Shanghai, China
- Bingxin Gu
- Center for Biomedical Imaging, Fudan University, Shanghai, China
- Shaoli Song
- Department of Oncology, Fudan University Shanghai Medical College, Shanghai, China
- Shaoli Song
- Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Shanghai, China
- Shaoli Song
- Center for Biomedical Imaging, Fudan University, Shanghai, China
- Bo Zhang
- Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China
- Bo Zhang
- Pancreatic Cancer Multidisciplinary Center, Fudan University Shanghai Cancer Center, Shanghai, China
- Bo Zhang
- Department of Oncology, Fudan University Shanghai Medical College, Shanghai, China
- Bo Zhang
- Pancreatic Cancer Institute, Fudan University, Shanghai, China
- Bo Zhang
- Shanghai Pancreatic Cancer Institute, Shanghai, China
- Wei Wang
- Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China
- Wei Wang
- Pancreatic Cancer Multidisciplinary Center, Fudan University Shanghai Cancer Center, Shanghai, China
- Wei Wang
- Department of Oncology, Fudan University Shanghai Medical College, Shanghai, China
- Wei Wang
- Pancreatic Cancer Institute, Fudan University, Shanghai, China
- Wei Wang
- Shanghai Pancreatic Cancer Institute, Shanghai, China
- Jin Xu
- Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China
- Jin Xu
- Pancreatic Cancer Multidisciplinary Center, Fudan University Shanghai Cancer Center, Shanghai, China
- Jin Xu
- Department of Oncology, Fudan University Shanghai Medical College, Shanghai, China
- Jin Xu
- Pancreatic Cancer Institute, Fudan University, Shanghai, China
- Jin Xu
- Shanghai Pancreatic Cancer Institute, Shanghai, China
- Xianjun Yu
- Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China
- Xianjun Yu
- Pancreatic Cancer Multidisciplinary Center, Fudan University Shanghai Cancer Center, Shanghai, China
- Xianjun Yu
- Department of Oncology, Fudan University Shanghai Medical College, Shanghai, China
- Xianjun Yu
- Pancreatic Cancer Institute, Fudan University, Shanghai, China
- Xianjun Yu
- Shanghai Pancreatic Cancer Institute, Shanghai, China
- Si Shi
- Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China
- Si Shi
- Pancreatic Cancer Multidisciplinary Center, Fudan University Shanghai Cancer Center, Shanghai, China
- Si Shi
- Department of Oncology, Fudan University Shanghai Medical College, Shanghai, China
- Si Shi
- Pancreatic Cancer Institute, Fudan University, Shanghai, China
- Si Shi
- Shanghai Pancreatic Cancer Institute, Shanghai, China
- DOI
- https://doi.org/10.3389/fonc.2021.650266
- Journal volume & issue
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Vol. 11
Abstract
objectiveDespite the heterogeneous biology of pancreatic cancer, similar surveillance schemas have been used. Identifying the high recurrence risk population and conducting prompt intervention may improve prognosis and prolong overall survival.MethodsOne hundred fifty-six resectable pancreatic cancer patients who had undergone 18F-FDG PET/CT from January 2013 to December 2018 were retrospectively reviewed. The patients were categorized into a training cohort (n = 109) and a validation cohort (n = 47). LIFEx software was used to extract radiomic features from PET/CT. The risk stratification system was based on predictive factors for recurrence, and the index of prediction accuracy was used to reflect both the discrimination and calibration.ResultsOverall, seven risk factors comprising the rad-score and clinical variables that were significantly correlated with relapse were incorporated into the final risk stratification system. The 1-year recurrence-free survival differed significantly among the low-, intermediate-, and high-risk groups (85.5, 24.0, and 9.1%, respectively; p < 0.0001). The C-index of the risk stratification system in the development cohort was 0.890 (95% CI, 0.835–0.945).ConclusionThe 18F-FDG PET/CT-based radiomic features and clinicopathological factors demonstrated good performance in predicting recurrence after pancreatectomy in pancreatic cancer patients, providing a strong recommendation for an adequate adjuvant therapy course in all patients. The high-risk recurrence population should proceed with closer follow-up in a clinical setting.
Keywords
