Prognostic Value of Positron Emission Tomography in Advanced Cholangiocarcinoma: A Single-Institution Study and Literature Review

Background: Cholangiocarcinoma is an uncommon malignancy in Western countries. Previous studies from mostly Asian countries have suggested the prognostic value of 18F-fluorodeoxyglucose positron-emission tomography integrated with computerized tomography (PET/CT) for advanced cholangiocarcinoma. Here, we investigated the prognostic value of PET/CT at our institution. Methods: A retrospective cohort study based on medical record review was conducted for patients with advanced cholangiocarcinoma who underwent treatment from January 2009 to January 2019 at a large academic institution in the United States. The outcomes of interest were overall survival. Multivariable analyses were performed to characterize the relationship between survival and the highest maximum standardized uptake value (SUVmax) from baseline PET/CT scans. Results: Analyses included data from 61 patients. The median age was 68.9 years and 87% of patients were White. The median highest SUVmax was 8.7 (range: background value to 22.8). In a multivariable analytic model including SUVmax, patient demography, and baseline laboratory parameters, SUVmax was identified as one of the independent predictors of survival higher SUVmax significantly predicted worse survival, with hazard ratio 2.26 (95% CI: 1.07-4.75, p=0.03). White race, higher albumin level, younger age, and lower cancer antigen (CA) 19-9 levels were associated with a decreasing risk of death. Conclusion: In this single-institution retrospective analysis, we found that baseline SUVmax was one of the significant prognostic factors for patients with advanced cholangiocarcinoma.