A Novel Validated Recurrence Stratification System Based on 18F-FDG PET/CT Radiomics to Guide Surveillance After Resection of Pancreatic Cancer
Open Access
- 12 May 2021
- journal article
- research article
- Published by Frontiers Media SA in Frontiers in Oncology
Abstract
objective: Despite 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. Methods: One 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. Results: Overall, 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). Conclusion: The 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.Funding Information
- National Natural Science Foundation of China
This publication has 52 references indexed in Scilit:
- Serum carbohydrate antigen 19-9 represents a marker of response to neoadjuvant therapy in patients with borderline resectable pancreatic cancerHPB, 2014
- Cancer heterogeneity: implications for targeted therapeuticsBritish Journal of Cancer, 2013
- DPC4 Gene Status of the Primary Carcinoma Correlates With Patterns of Failure in Patients With Pancreatic CancerJournal of Clinical Oncology, 2009
- Adjuvant 5-fluorouracil and folinic acid vs observation for pancreatic cancer: composite data from the ESPAC-1 and -3(v1) trialsBritish Journal of Cancer, 2009
- Adjuvant Chemotherapy With Gemcitabine vs Observation in Patients Undergoing Curative-Intent Resection of Pancreatic CancerJAMA, 2007
- Smad4 is dispensable for normal pancreas development yet critical in progression and tumor biology of pancreas cancerGenes & Development, 2006
- Positron Emission Tomography/Computed Tomography Influences on the Management of Resectable Pancreatic Cancer and Its Cost-EffectivenessAnnals of Surgery, 2005
- X-TileClinical Cancer Research, 2004
- Presentation of multivariate data for clinical use: The Framingham Study risk score functionsStatistics in Medicine, 2004
- A Randomized Trial of Chemoradiotherapy and Chemotherapy after Resection of Pancreatic CancerThe New England Journal of Medicine, 2004