Impact of retention index on the neoadjuvant chemotherapy effect and the prognosis in oesophageal cancer.

Abstract

The relationship between retention index calculated from dual-time point 18F-fluorodeoxyglucose positron emission tomography-computed tomography and oesophageal cancer prognosis remains unknown. This study aimed to determine usefulness of retention index as a predictor of long-term prognosis of oesophageal cancer and neoadjuvant chemotherapy efficacy. A total of 151 patients with oesophageal cancer who underwent esophagectomy were evaluated retrospectively in this study. We acquired positron emission tomography scans 60 and 120min (SUVmax1 and SUVmax2, respectively) after the intravenous administration of 3.7 Mbq/kg 18F-fluorodeoxyglucose. The patients were divided into two groups: high-retention index (retention index ≥29%, 107 patients) and low-retention index (retention index <29%, 44 patients). Retention index was calculated as follows: retention index (%)=[(SUVmax2 - SUVmax1)/SUVmax1]×100. The overall survival and relapse-free survival rates in the high-retention index group were significantly lower than those in the low-retention index group (P<0.001). Our multivariate analysis identified that the high-retention index group contained independent risk factors for overall survival (hazard ratio: 2.44, P=0.009) and relapse-free survival (hazard ratio: 2.61, P=0.002). The high-retention index group exhibited a lower partial response rate to neoadjuvant chemotherapy evaluated by computed tomography (P<0.001) and a lower pathological therapeutic effect in the resected specimen (P=0.019) than the low-retention index group. The retention index was associated with neoadjuvant chemotherapy responses and long-term prognosis for oesophageal cancer.