Locally advanced esophageal adenocarcinoma: Response to neoadjuvant chemotherapy and survival predicted by[18F]FDG-PET/CT

• DOI: 10.3109/0284186x.2011.643822
• Publication Date: 2012-01-02T11:03:55Z
• Authors: Juha T. Kauppi; Niku Oksala; Jarmo A. Salo; Heikki Helin; Lauri Karhumäki; Jukka Kemppainen; Eero I. Sihvo; Jari V. Räsänen
• Keywords: Neoadjuvant Therapy; Standardized uptake value; Univariate analysis; Esophagectomy

Background. [18F]fluorodeoxyglycose-Positron Emission Tomography/Computer Tomography ([18F]FDG-PET/CT) is commonly used in staging of locally advanced esophageal cancer. Its predictive value for response to neoadjuvant therapy and survival after multimodality controversial. Methods. Sixty-six consecutive patients with adenocarcinoma the esophagus or esophagogastric junction underwent surgery chemotherapy. Staging was done prospectively [18F]FDG-PET/CT, before completion therapy. Pre- post-therapy maximal standardized uptake values primary tumor (SUV1 SUV2) were determined, their relative change (SUV∆%) calculated. Percentage SUV1 compared histopathologic (HPR, complete subtotal histologic remission), disease-free- (DFS) overall (OS). Results. Resection negative margins achieved 60 patients. HPR rate 14 66 (21.2%). Median follow-up 16 months (range 4–72). For all patients, OS probability at three years 59% DFS 50%. In receiver operating characteristics (ROC) analysis, optimally predicted by a > 67% baseline SUV (sensitivity 79% specificity 75%). univariate analysis (Cox regression proportional hazards), associated improved (HR 0.208, p = 0.033) but not 0.030, 0.101), % 0.249, 0.027) 0.383, 0.040). multivariate model (adjusted age, sex, ASA score), neither nor SUV∆% DFS. However, as continuous variable an independent predictor 0.966, < 0.0001) 0.973, 0.0001). Conclusion. Our results support previous showing that [18F]FDG-PET/CT can distinguish group worse prognosis chemotherapy junction. This information could offer new preoperative marker prognosis.