Analysis of relationship between (18)F-FDG PET/CT SUVmax of esophageal squamous cell carcinoma before treatment and postoperative survival

Abstract

Objective: To evaluate the value of (18)F-FDG PET/CT in predicting long-term survival of esophageal squamous cell carcinoma(ESCC) before initial treatment. Methods: A total of 167 ESCC patients were retrospectively analyzed who underwent surgery between January 2010 and December 2014 in prospective database of Peking University Cancer Hospital Thoracic Surgery Department One, all cases were included according to inclusion and exclusion criteria.The relationship between SUVmax of the primary tumor and patients' age, gender, tumor location, tumor differentiation, tumor regression grade as well as long term survival were compared. Results: The median follow-up time of the 167 cases was 46.9 months(ranging from 30.5 to 86.2 months), with 1 year and 3 years postoperatively being 95.1% and 68.4%, respectively.The SUVmax of the tumor was positively correlated with cT(P<0.01), cN(P=0.033), cTNM(P=0.002) and pTNM(P=0.003)of the tumor.Patients with SUVmax ≤6 obtained a survival significantly better compared with patients with SUVmax>6, the 3 years OS were 83.4 % vs 65.6% (P=0.02) , and DFS were 82.4% vs 55.4%(P=0.006), respectively.The multivariate regression analysis demonstrated that the SUVmax>6 before treatment was the independent prognostic factor for OS (HR=3, 95%CI 1.050-8.568) and DFS (HR=3.971, 95% CI 1.408-11.200) of the ESCC patients. Conclusions: The higher the (18)F-FDG PET/CT SUVmax of the ESCC primary tumor, the poorer survival of the patients. Therefore, SUVmax could be used as an indicator to predict long term survival of the ESCC patients before treatment.