P-89 Real-world utility of full staging with 18-fluorodeoxyglucose positron emission tomography (18FDG-PET) in addition to standard imaging in patients with non-metastatic non-resectable pancreatic ductal adenocarcinoma (PDAC)

Previous studies support 18FDG-PET utility for staging of patients (pts) with non-metastatic PDAC (M0-PDAC); while its use has been adopted in some countries (i.e. NICE guidelines the United Kingdom), this setting is variable, especially relation to non-resectable disease. This study explored performing real-world clinical practice pts a working diagnosis M0-PDAC based on cross-sectional imaging. Notes from consecutive seen at The Christie NHS Foundation Trust (01/07/2018-02/02/2022; Audit Committee approval: 2020/2654) were reviewed. Eligible those (with primary tumour situ) who underwent full an (standard all during time period explored). end-point was percentage identified have distant metastases 18FDG-PET. Secondary objectives: factors associated presence metastases, and impact findings patient outcomes (overall survival (OS); defined as when first consideration systemic therapies death or last follow-up). Statistical analysis: STATA v.17, including logistic Cox Regression. A total 1637 screened; these, 56 eligible. Thirty (53.37%) male; median age: 72 years (range 34-83); majority had located head (n=40, 71.43%), ECOG performance Status (ECOG PS) 0/1 (n=48, 85.71%) none/mild comorbidities (37 pts, 66.07%; 22 (39.29%) diabetes) treatment naive (52 92.86%; 4 received prior chemotherapy (all FOLFIRINOX)); stage 18FDG-PET: T4 (39 patients; 69.64%), regional lymph node disease (25 44.64%), M0 (56 100%). In 19 (33.93%) metastatic disease; incidental 12 (21.50%) (incidental 7 without evidence 18FDG-PET). Logistic regression (vs T1/2/3 stage) only factor associate higher risk (46.15% vs 5.88%; Odds Ration (OR) 13.71 (95% 1.65-113.81); p-value 0.015). At analysis 31 (55.36%) died; follow up 8.54 months CI 6.10-10.64). Estimated OS whole population 12.53 9.16-14.74). Patients shorter (8.07 4.23-16.53) 14.38 11.01-19.17)); prognostic confirmed multivariable Regression (HR 3.48 1.76-12.04); 0.002) adjusted other (PS 1.57-7.71); 0.002)). allows identification otherwise occult third (this rate disease). Staging should be considered standard care allow access appropriate standard-of-care options recruitment into trials. addition, implications could enable optimisation information given, management expectations future planning.