Abstract
Objective:We aimed to investigate the SUVmax of primary tumor and metastatic lymph node in predicting survival in patients with esophageal cancer.Methods:We retrospectively analyzed patients with esophageal cancer between 2009 and 2011 who had FDG positron-emission tomography (PET)/computed tomography (CT). All patients were followed-up to 2013. Clinical staging, SUVmax of primary tumor and metastatic lymph node were evaluated.Results:One hundred seven patients were included in the study. All patients were followed-up between 2 and 49 months. The mean SUVmax of primary tumor and metastatic lymph node were 19.3±8.8 and 10.4±9.1, respectively. Metastatic lymph node SUVmax had an effect in predicting survival whereas primary tumor SUVmax did not have an effect (p=0.014 and p=0.262, respectively). Multivariate Cox regression analysis showed that clinical stage of the disease was the only independent factor predicting survival (p=0.001).Conclusion:Among patients with esophageal cancer, the value of primary tumor SUVmax did not have an effect on survival. Clinical stage assessed with FDG PET/CT imaging was found to predict survival in esophageal carcinoma. Additionally, lymph node SUVmax was identified as a new parameter in predicting survival in the present study.
Highlights
Esophageal cancer constitutes 1.5-2% of all cancers and 5-7% of those in the gastrointestinal tract
Endoscopic biopsy revealed in situ squamous cell carcinoma in three patients, and no pathologic FDG uptake was identified on their positronemission tomography (PET)/computed tomography (CT) scans
Our findings suggest that the SUVmax of the primary tumor as determined by FDG positron-emission tomography/computed tomography (PET/CT) imaging that is used for staging patients with esophageal cancer is not predictive of survival
Summary
Esophageal cancer constitutes 1.5-2% of all cancers and 5-7% of those in the gastrointestinal tract. It is one of the most lethal of all cancers, and is known to be aggressive, showing significant progression in early stages via metastasis. Long-term survival is low, despite appropriate treatment. The assessment of survival in advance plays an important role in the treatment of the disease [1,2,3,4]. The significance of positron-emission tomography/computed tomography (PET/CT) imaging in clinical staging is well known, numerous studies have evaluated the effect of the maximum standard uptake value (SUVmax) obtained via PET/CT before surgery on survival. There are no clinical studies on the effect of metastatic lymph node SUVmax on survival in esophageal cancer
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