scholarly journals The clinical application of18F-fluorodeoxyglucose positron emission tomography to predict survival in patients with operable esophageal cancer

Cancer ◽  
2009 ◽  
Vol 115 (14) ◽  
pp. 3196-3203 ◽  
Author(s):  
Hiroyuki Kato ◽  
Masanobu Nakajima ◽  
Makoto Sohda ◽  
Naritaka Tanaka ◽  
Takanori Inose ◽  
...  
Keyword(s):  
Positron Emission Tomography ◽  
Esophageal Cancer ◽  
Clinical Application ◽  
Emission Tomography ◽  
Fluorodeoxyglucose Positron Emission Tomography ◽  
Positron Emission ◽  
Fluorodeoxyglucose Positron Emission

scholarly journals Outcomes of Patients With Esophageal Cancer Staged With [18F]Fluorodeoxyglucose Positron Emission Tomography (FDG-PET): Can Postchemoradiotherapy FDG-PET Predict the Utility of Resection?

2010 ◽  
Vol 28 (31) ◽  
pp. 4714-4721 ◽  
Author(s):  
Arta Monir Monjazeb ◽  
Greg Riedlinger ◽  
Mebea Aklilu ◽  
Kim R. Geisinger ◽  
Girish Mishra ◽  
...  
Keyword(s):  
Positron Emission Tomography ◽  
Esophageal Cancer ◽  
Fdg Pet ◽  
Prospective Trial ◽  
Emission Tomography ◽  
Fluorodeoxyglucose Positron Emission Tomography ◽  
Trimodality Therapy ◽  
Positron Emission ◽  
Improved Outcomes ◽  
Fluorodeoxyglucose Positron Emission

Purpose To determine whether [18F]fluorodeoxyglucose positron emission tomography (FDG-PET) can delineate patients with esophageal cancer who may not benefit from esophagectomy after chemoradiotherapy. Patients and Methods We reviewed records of 163 patients with histologically confirmed stage I to IVA esophageal cancer receiving chemoradiotherapy with or without resection with curative intent. All patients received surgical evaluation. Initial and postchemoradiotherapy FDG-PET scans and prognostic/treatment variables were analyzed. FDG-PET complete response (PET-CR) after chemoradiotherapy was defined as standardized uptake value ≤ 3. Results Eighty-eight patients received trimodality therapy and 75 received chemoradiotherapy. Surgery was deferred primarily due to medical inoperability or unresectable/metastatic disease after chemoradiotherapy. A total of 105 patients were evaluable for postchemoradiotherapy FDG-PET response. Thirty-one percent achieved a PET-CR. PET-CR predicted for improved outcomes for chemoradiotherapy (2-year overall survival, 71% v 11%, P < .01; 2-year freedom from local failure [LFF], 75% v 28%, P < .01), but not trimodality therapy. On multivariate analysis of patients treated with chemoradiotherapy, PET-CR is the strongest independent prognostic variable (survival hazard ratio [HR], 9.82, P < .01; LFF HR, 14.13, P < .01). PET-CR predicted for improved outcomes regardless of histology, although patients with adenocarcinoma achieved a PET-CR less often. Conclusion Patients treated with trimodality therapy found no benefit with PET-CR, likely because FDG-PET residual disease was resected. Definitive chemoradiotherapy patients achieving PET-CR had excellent outcomes equivalent to trimodality therapy despite poorer baseline characteristics. Patients who achieve a PET-CR may not benefit from added resection given their excellent outcomes without resection. These results should be validated in a prospective trial of FDG-PET–directed therapy for esophageal cancer.

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