Prognostic value of quantitative parameters for esophageal squamous cell carcinoma determined by preoperative FDG-PET after trimodal therapy.
Surgery
; 172(2): 584-592, 2022 08.
Article
em En
| MEDLINE
| ID: mdl-35523595
ABSTRACT
BACKGROUND:
Associations between tumor metabolic and volumetric parameters determined by preoperative 18F-fluorodeoxyglucose-positron emission tomography and survival in patients with esophageal squamous cell carcinoma who underwent trimodal therapy have not been fully investigated.METHODS:
We evaluated relationships between reductions in maximal standardized uptake value, metabolic tumor volume, and total lesion glycolysis in primary tumors on 18F-fluorodeoxyglucose-positron emission tomography images between before and after neoadjuvant chemoradiotherapy and the survival of 120 patients with esophageal squamous cell carcinoma who underwent neoadjuvant chemoradiotherapy followed by surgery.RESULTS:
The optimal cutoffs of Δ maximal standardized uptake value, Δ metabolic tumor volume, and Δ total lesion glycolysis were defined to statistically yield the largest differences in recurrence-free survival for good and poor positron emission tomography responders to neoadjuvant chemoradiotherapy (cutoffs 70%, 85%, and 90%, respectively). These cutoff values significantly stratified overall survival (Δ maximal standardized uptake value, P = .004; Δ metabolic tumor volume, P = .001; Δ total lesion glycolysis, P < .0001). Univariate analysis showed that Δ maximal standardized uptake value (hazard ratio, 0.50; 95% confidence interval, 0.32-0.79; P = .003), Δ metabolic tumor volume (hazard ratio, 0.50; 95% confidence interval, 0.31-0.81; P = .004), and Δ total lesion glycolysis (hazard ratio, 0.37; 95% confidence interval, 0.23-0.61; P < .001) were statistically significant for recurrence-free survival. Furthermore, Δ metabolic tumor volume (hazard ratio, 0.45; 95% confidence interval, 0.27-0.76; P = .003) and Δ total lesion glycolysis (hazard ratio, 0.37; 95% confidence interval, 0.22-0.63; P < .001) were independent factors for recurrence-free survival in multivariate analyses that included preoperative and pathological factors.CONCLUSION:
Together with significant pathological prognostic factors, Δ metabolic tumor volume and Δ total lesion glycolysis were valuable for patients with esophageal squamous cell carcinoma who received trimodal therapy. Thus, preoperative 18F-fluorodeoxyglucose-positron emission tomography is a useful and noninvasive diagnostic tool that might facilitate tailoring optimal therapies for locally advanced esophageal squamous cell carcinoma.
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Base de dados:
MEDLINE
Assunto principal:
Neoplasias Esofágicas
/
Carcinoma de Células Escamosas
/
Carcinoma de Células Escamosas do Esôfago
Idioma:
En
Ano de publicação:
2022
Tipo de documento:
Article