The prognosis including ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography (¹⁸F-FDG-PET/CT) for the early recurrence for hepatocellular carcinoma (HCC) after living donor liver transplantation (LDLT) was not well established. Consecutive patients who underwent ¹⁸F-FDG-PET/CT and subsequent LDLT for HCC from March 2005 to June 2011 were enrolled. The 191 patients with a median follow-up of 26.1 months were evaluated. There were 20 patients (10.5%) with early recurrence (≤6 months), 18 patients (9.4%) with late recurrence (>6 months), and 153 patients (80.1%) with no recurrence. Fifty-five patients (28.8%) displayed increased PET/CT tumor uptake. Three-year overall and disease-free survival for PET/CT-positive patients were 65.5% and 57.1%, respectively, while PET/CT-negative patients showed respective values of 89.8% and 86.8% (P = 0.001 vs. P < 0.001). Tumor variables associated with PET/CT-positive finding were preoperative AFP level, Milan, UCSF criteria, maximum tumor size, total tumor size, differentiation, vascular invasion, and serosal invasion. PET/CT-positive status was identified as an independent prognostic factor for disease-free survival influencing early recurrence in multivariable analysis (HR 3.945, 95% CI 1.196–13.016, P = 0.024). ¹⁸F-FDG-PET/CT is an independent and significant predictor of early tumor recurrence in LDLT for HCC.

Background: The purpose of this study was to determine the effect of blood glucose level correction on pancreatic cancer prognosis predictions after curative resection using F-18 fluorodeoxyglucose positron emission tomography (FDG PET). Methods: We enrolled 43 patients with pancreatic cancer who underwent preoperative FDG PET. Patient outcomes were categorized according to cancer recurrence in the clinical period. Maximum standardized uptake values (SUV_max) of tumors were measured using FDG PET, and blood glucose-corrected SUV (SUV_gluc) was calculated as SUV_max × blood glucose level/100. Results: Pancreatic cancer recurrence was observed within 9 months in 24 of 43 patients. SUV_gluc, but not SUV_max, was significantly higher in the recurrence group than in the nonrecurrence group. Receiver operating characteristic analysis revealed that SUV_gluc of 4.8 and SUV_max of 3.0 were the best cutoff values for predicting tumor recurrence. The 9-month recurrence-free survival rates were 72.3% for patients with SUV_gluc ≤4.8, 23.5% for patients with SUV_gluc >4.8, 75.0% for patients with SUV_max ≤3.0, and 45.0% for patients with SUV_max >3.0. SUV_gluc was determined to be a significant predictive factor for tumor recurrence, along with differentiation, whereas SUV_max was not. Conclusion: SUV_gluc on FDG PET aids in better predicting the prognosis of patients with pancreatic cancer after curative resection than does SUV_max without correction.

Rationale: The activity of aldehyde dehydrogenase 7A1 (ALDH7A1), an enzyme that catalyzes the lipid peroxidation of fatty aldehydes was found to be upregulated in pancreatic ductal adenocarcinoma (PDAC). ALDH7A1 knockdown significantly reduced tumor formation in PDAC. We raised a question how ALDH7A1 contributes to cancer progression.

Background: The present study assessed whether early palliative care (EPC) targeting pain and depression and automated symptom monitoring could improve symptoms in patients with advanced pancreatobiliary cancer. Methods: Patients diagnosed with pathologically confirmed locally advanced or metastatic pancreatic or biliary tract cancer who had cancer-related pain (brief pain inventory (BPI) worst pain score >3) and/or depression (Center for Epidemiological Studies—Depression Scale (CES-D) >16) were randomized within 8 weeks after diagnosis to receive EPC or on-demand palliative care (n = 144 each). EPC included (1) nursing assessment of pain and depression, (2) pain control based on National Comprehensive Cancer Network guidelines, (3) depression control by psychoeducation and/or consultation with a psychiatric specialist, and (4) patient education. The primary end points were ≥50% reductions from baseline to week 4 in pain and depression scores. Results: The proportion of patients in the EPC and usual care groups with ≥50% reductions in pain (29.5% vs. 25.2%; p = 0.4194) and depression (30.8% vs. 36.8%; p = 0.5732) scores from baseline to week 4 did not differ significantly. The proportion of patients with BPI worst pain score ≤3 was significantly higher (51.1% vs. 38.9%, p = 0.0404) and the reduction in pain intensity score significantly greater (1.5 vs. 1.0 points, p = 0.0318) in the EPC than in the usual care group. At 4 weeks, patients in the EPC group reported significant increases in global health status, role of functioning, nausea and vomiting, and pain scores on the European Organization for Research and Treatment of Cancer Core Quality of Life questionnaire (EORTC QLQ-C30) general questionnaire. Conclusions: Although the primary outcome was not met, this trial indicates that EPC may improve early pain relief in patients with advanced pancreatobiliary cancers.