Int J Clin Oncol. 2026 Mar 31. doi: 10.1007/s10147-026-03023-0. Online ahead of print.
ABSTRACT
BACKGROUND: Excessive accumulation of visceral adipose tissue (VAT), or obesity, has an association with cholangiocarcinoma prognosis. We hypothesized that qualitative assessment of VAT would have prognostic significance as well as quantitative assessment. The aim of this study was to measure 18F-fluorodeoxyglucose (18F-FDG) uptake in visceral fat by 18F-FDG positron emission tomography/computed tomography (18F-FDG-PET/CT) and to investigate the prognostic significance of the qualitative assessment of VAT.
METHODS: We retrospectively studied 103 patients with extrahepatic cholangiocarcinoma who underwent surgical resection from April 2017 to April 2023. 18F-FDG-PET/CT was performed before surgery, and the standardized uptake value (SUV) of VAT and blood pool were measured. The VAT-to-blood pool SUV ratio (VBR) was calculated as the ratio of VAT-SUV to blood pool SUV.
RESULTS: The optimal VBR cutoff value to predict overall survival (OS) was 0.360. Compared with the low VBR group, the high VBR group was significantly associated with lower body mass index, skeletal muscle index, visceral fat area, subcutaneous fat area, and liver SUV. In the multivariate analysis, patients with a high VBR had poorer OS compared with those with a low VBR. Moreover, the VBR was significantly higher in patients with vs without malnutrition by the GLIM criteria. The VBR showed the lowest Akaike information criteria statistic value among the assessed parameters, indicating that it had the best ability to predict OS.
CONCLUSIONS: This study suggested that the VBR, determined by 18F-FDG-PET/CT, is associated with the malnutrition and poor OS after resection of extrahepatic cholangiocarcinoma.
PMID:41917337 | DOI:10.1007/s10147-026-03023-0
