Predicting outcomes in pancreatic cancer before surgery remains a challenge, as no reliable preoperative prognostic markers have been established. This study investigated whether 18-fluorodeoxyglucose positron emission tomography/computed tomography (18-FDG-PET/CT) could serve as a prognostic tool in patients eligible for pancreatic resection. We retrospectively reviewed patients who underwent preoperative PET scans followed by surgical resection from January 2007 to December 2015. The maximum standardized uptake value (SUVmax) from PET/CT was recorded, and patients were divided into high (>3.65) and low (≤3.65) SUVmax groups. These groups were compared across TNM stage, tumor differentiation, type of surgery, margin status, lymph node involvement, age, sex, diabetes, and serum CA 19-9 levels. Among 144 patients, 82 had high SUVmax tumors, and 62 had low SUVmax tumors. Survival analysis revealed that disease-free and overall survival were strongly associated with tumor stage, nodal status, grade, resection margins, and SUVmax. Patients with low SUVmax (≤3.65) experienced significantly longer survival than those with high SUVmax (>3.65, p < 0.001). Multivariate analysis identified these factors as independent predictors of outcome. These findings indicate that SUVmax on 18-FDG-PET/CT is a valuable prognostic marker for resectable pancreatic cancer and may assist clinicians in planning individualized treatment strategies.
