2-Fluoro-2-deoxy-D-glucose positron emission tomography imaging is predictive of pathologic response and survival after preoperative chemoradiation in patients with esophageal carcinoma.

Swisher SG, Erasmus J, Maish M, Correa AM, Macapinlac H, Ajani JA, Cox JD, Komaki RR, Hong D, Lee HK, Putnam JB, Rice DC, Smythe WR, Thai L, Vaporciyan AA, Walsh GL, Wu TT, Roth JA
Cancer. 2004 101 (8): 1776-85

PMID: 15386332 · DOI:10.1002/cncr.20585

BACKGROUND - The current study was performed to assess the value of 2-fluoro-2-deoxy-d-glucose positron emission tomography (FDG-PET) in predicting the pathologic response and survival of patients with esophageal carcinoma treated with preoperative chemoradiation (CRT) and tumor resection. Preliminary reports suggest that FDG-PET may be predictive of the response of esophageal carcinoma patients to preoperative CRT.

METHODS - Eighty-three patients with resectable esophageal carcinoma who underwent preoperative CRT and FDG-PET and tumor resection were evaluated for pathologic response to CRT, percent residual tumor, and survival.

RESULTS - The majority of patients in the current study were men (74 of 83 patients; 89%). Most tumors were adenocarcinomas (73 of 83 tumors; 88%) and clinical (EUS)T3/4 (69 tumors; 83%) or N1 (46 tumors; 55%). FDG-PET after preoperative CRT identified pathologic responders but failed to rule out microscopic residual tumor in 13 of 73 cases (18%). Pathologic response was found to correlate with the post-CRT FDG-PET standardized uptake value (SUV) (P = 0.03) and a post-CRT FDG-PET SUV of or 4 was found to be the only preoperative factor to correlate with decreased survival (2-year survival rate of 33% vs. 60%; P = 0.01). On univariate Cox regression analysis, only post-CRT FDG-PET was found to be correlated with post-CRT survival (P = 0.04).

CONCLUSIONS - Post-CRT FDG-PET was found to be predictive of pathologic response and survival in patients with esophageal carcinoma who undergo preoperative CRT. Esophagectomy should still be considered even if the post-CRT FDG-PET scan is normal because microscopic residual disease cannot be ruled out.

MeSH Terms (22)

Adenocarcinoma Adult Aged Carcinoma, Squamous Cell Combined Modality Therapy Esophageal Neoplasms Female Fluorodeoxyglucose F18 Humans Male Middle Aged Neoplasm Staging Predictive Value of Tests Preoperative Care Prognosis Radiopharmaceuticals Remission Induction Retrospective Studies Risk Factors Sensitivity and Specificity Survival Rate Tomography, Emission-Computed

Connections (1)

This publication is referenced by other Labnodes entities: