Preoperative 18F-FDG PET-CT Maximum Standardized Uptake Value Predicts Recurrence of Biliary Tract Cancer

: (18)F-Fluorodeoxyglucose positron-emission with computed tomography ((18)F-FDG PET-CT) is an imaging technique based on the increased uptake of glucose characteristically seen in malignant lesions. The preoperative maximum standardized uptake value (SUVmax) of PET-CT has been identified as a powerful significant prognostic factor for predicting recurrence in malignant tumors. Therefore, the aim of this study was to determine whether (18)F-FDG PET-CT has a prognostic significance in patients with biliary tract cancer after surgical resection. From April 2006 to February 2013, 64 patients who underwent curative resection for biliary tract cancer were reviewed retrospectively. Clinical diagnoses of patients were: intrahepatic cholangio-carcinoma (n=6), hilar cholangiocarcinoma (n=6), extrahepatic cholangiocarcinoma (n=22), gall bladder cancer (n=14) and ampullar cancer (n=16). The mean preoperative SUVmax value was 5.1±4.7. The mean follow-up duration was 27 months. Recurrence-free survival at 1, 2 and 5 years were 75.9%, 63.3% and 47.1%. In the univariate analysis, N stage, poor tumor differentiation, the presence of lymphatic invasion and high SUVmax (>5.0) were significant risk factors for recurrence. The multivariate analysis showed a high preoperative SUVmax (>5.0) to be an independent risk factor for tumor recurrence (p=0.008). In conclusion, preoperative SUVmax of the primary tumor was significantly associated with recurrence in patients with biliary tract cancer.