The relationship between 18 F-FDG uptake on PET/CT and markers of systemic inflammatory response in patients undergoing surgery for intrahepatic cholangiocarcinoma

Abstract

Background/Aim: This study evaluated the prognostic relationship between tumor 18 F-fluorodeoxyglucose (FDG) uptake on positron-emission tomography (PET)/computed tomography (CT) imaging and markers of systemic inflammatory response (SIR) in patients undergoing surgery for intrahepatic cholangiocarcinoma (ICC). Patients and Methods: Between 2002 and 2016, 94 patients with ICC who underwent 18 F-FDG-PET scans before surgery were analyzed. 18 F-FDG uptake was quantified as a maximum standardized uptake value (SUVmax). The neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and C-reactive protein (CRP) were selected as SIR markers. Results: There was no strong correlation between SUVmax and, NLR, PLR and CRP (all Pearson’s |r| <0.40). Multivariate Cox regression analyses identified high tumor SUVmax (≥8) and high NLR (≥5) as independent predictors of poor overall survival (p=0.013 and p=0.002) and disease-free survival (p<0.001 and p=0.004). Conclusion: Prognostic information provided by tumor SUVmax and SIR markers may be independent prognostic factors in patients undergoing surgery for ICC.