ASO Author Reflections: The Feasibility of Preoperative FDG-Positive Lymph Nodes of Resectable Biliary Tract Cancers for Postoperative Prognosis

Abstract

F-18 fluorodeoxyglucose-positron emission tomography (FDG-PET) has been used for various cancers to predict their prognoses, including gastrointestinal and pancreatic cancers. However, in biliary tract cancer (BTC), it is difficult to distinguish FDG uptake caused by cancer or inflammation due to the accompanying cholangitis. Our previous report demonstrated a possibility that FDG-PETpositive lymph nodes (LNs), using a maximum standard uptake value (SUVmax) cut-off of 2.8, correlated with prognosis in 36 patients with resectable BTC. Moreover, multivariate analysis identified that an LN SUVmax of C2.8 [PET N (?); hazard ratio 3.597, p = 0.0230] and curative resection were significant and independent prognostic factors. The limitation of this previous study was the small number of patients and the lack of validation for use.