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J Nucl Med. 2008; 49 (Supplement 1):59P
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Oncology-Clinical Diagnosis: Solid Tumors

GI Cancers - Esophagus, Gastric and Pancreas

Pretreatment metabolic tumor volume measured by FDG-PET predicts survival in squamous cell carcinoma of the esophagus

Seung Hyup Hyun1, Joon Young Choi1, Young Mog Shim2, Kwhanminem Kim2, Su Jin Lee1, Young-Seok Cho1, Ji Young Lee1, Eun Jeong Lee1, Kyung-Han Lee1 and Byung-Tae Kim1

1 Nuclear Medicine; 2 Thoracic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea


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Objectives: FDG-PET findings have been suggested to be useful prognostic indicators in esophageal cancer. However, the prognostic significance of pretreatment metabolic tumor volume (MTV) measured by FDG-PET remains uncertain. Therefore, we investigated the prognostic value of pretreatment MTV for the primary lesion in patients with squamous cell carcinoma (SCC) of the esophagus.

Methods: One hundred forty-six consecutive patients (133 men, 13 women; median age, 62 years) with esophageal SCC underwent FDG-PET for initial staging. MTV was determined by the threshold contouring method derived from our previous pathologic correlation study. Overall survival was assessed by the Kaplan-Meier method. Maximally-selected rank statistics were used to determine the optimal cutoffs. The prognostic significance of MTV and other clinical variables was assessed by univariate and multivariate analyses.

Results: Curative surgery was performed for 112 patients with early stage disease. Non-surgical treatment (chemoradiation therapy or palliative management) was done for 34 patients with inoperable disease. Patients were followed for a median 41.5 months. In univariate analysis, MTV (cutoff: 4 cm3, 22 cm3), maximum SUV of primary tumor (cutoff: 6), initial stage, and operability were significant predictors of overall survival. The multivariate analysis showed that only MTV (p < 0.001) and operability (p < 0.001) were independent prognostic factors for overall survival.

Conclusions: The pretreatment FDG-PET based MTV of the primary lesion is a significant predictor of overall survival in patients with esophageal SCC.





This Article
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Right arrow Email this article to a friend
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Right arrow Alert me to new issues of the journal
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Right arrow Articles by Kim, B.-T.
PubMed
Right arrow Articles by Hyun, S. H.
Right arrow Articles by Kim, B.-T.