The Role of Computed Tomography-Determined Total Tumor Volume at Baseline in Predicting Outcomes of Patients with Locally Advanced Unresectable or Metastatic Pancreatic Ductal Adenocarcinoma

作者：Elissar Moujaes, Jules Dupont, Littisha Lawrance, Fiona Frau, G. Jardali, Lama Dawi, Michèle Kind, Caroline Su, Samy Ammari, Nohad Masri, Anamaria Bianca Mihele, Valérie Boige, T. Pudlarz, Cristina Smolenschi, M. Valery, Géraldine M. Camilleri, Alice Boilève, Michel Ducreux, N. Lassau, Antoine Hollebecque · 发表于：Cancers · 年份：2025 · DOI：10.3390/cancers18010020 · 被引用次数：1 · 研究领域：Pancreatic and Hepatic Oncology Research、Inflammatory Biomarkers in Disease Prognosis、Radiomics and Machine Learning in Medical Imaging

Background: Total tumor volume (TTV), derived from imaging data, has emerged as a potential prognostic biomarker in various cancers. This study aimed to evaluate the impact of TTV on outcomes in advanced pancreatic ductal adenocarcinoma (PDAC) and to validate a survival prediction model combining TTV with baseline clinico-biological markers. Materials and Methods: We conducted a retrospective analysis of 150 patients with locally advanced or metastatic PDAC treated with first-line FOLFIRINOX from 2010 to 2021. TTV was calculated by manually segmenting all visible lesions on baseline CT scans. Progression-free survival (PFS) and overall survival (OS) were the primary endpoints. A cut-off value for TTV predicting 6-month PFS was determined in 140 patients using AUC and Youden’s Index and then applied to OS analysis. A multivariate Cox regression model incorporating TTV, CA 19-9, and neutrophil-to-lymphocyte ratio (NLR) was developed in 94 patients to establish a survival risk score. Results: 12,028 lesions were annotated. OS was slightly but significantly different between TTV above and below the median value of 69.60 cm3 (12.4 vs. 13.5 months, p = 0.0269). A cut-off of 400 cm3 distinguished two groups: patients with TTV > 400 cm3 had significantly shorter OS (9.4 months) compared to those with TTV ≤ 400 cm3 (13.0 months, p = 0.0056). A similar trend was observed for PFS, though not statistically significant (7.4 months for TTV > 400 cm3 vs. 8.2 months for TTV ≤ 400 cm3, ...