Abstract
Esophageal squamous cell carcinoma (ESCC) is a major cancer prevalent in Asian males. Pretreatment tumor burden can be prognostic for ESCC. We studied the prognostic value of metabolic parameters of 2-deoxy-2-[18F] fluoro-D-glucose positron emission tomography/computed tomography (18F-FDG PET/CT) and the serum squamous cell carcinoma antigen (SCC-Ag) level in node-negative stage II ESCC patients. Eighteen males underwent staging evaluation were included. The volume-based metabolic parameters derived from 18F-FDG PET/CT, including metabolic tumor volume (MTV) and total lesion glycolysis (TLG), were obtained using the PET Volume Computer Assisted Reading application. The Spearman correlation coefficients were calculated to assess the relationship between metabolic parameters and pretreatment serum SCC-Ag levels. Based on the 5-year follow-up, patients were sub-divided into the demised and the stable groups. Potential prognostic value was assessed by independent t-test and the Mann–Whitney U test. The association of overall survival was assessed using univariate and multivariate Cox regression analyses. The demised group showed significant higher values in serum SCC-Ag, as well as in MTV and TLG, but not SUVmax and SUVmean. The SUVmax, MTV, TLG, and serum SCC-Ag showed significant association with overall survival. Our findings suggest potential usage of pretreatment volume-based metabolic parameters of 18F-FDG PET/CT and serum SCC-Ag as prognostic factors for node-negative stage II ESCC patients.
Highlights
Esophageal cancer is the eighth common cancer worldwide [1] and the fifth prevalent cancer in Taiwan [2]
While esophageal adenocarcinoma (EAC) is more common in North America and certain parts of Europe [3], Esophageal squamous cell carcinoma (ESCC) constitutes about 90% of esophageal cancers in Eastern Asia [4]
The current study aimed to evaluate the prognostic value of 18F- FDG PET/CT-derived volume-based metabolic parameters and serum squamous cell carcinoma antigen (SCC-Ag) in patients with ESCC staging II
Summary
Esophageal cancer is the eighth common cancer worldwide [1] and the fifth prevalent cancer in Taiwan [2]. ESCC and esophageal adenocarcinoma (EAC) are the two major histopathological subtypes of esophageal cancer. While EAC is more common in North America and certain parts of Europe [3], ESCC constitutes about 90% of esophageal cancers in Eastern Asia [4]. Integrating clinical information of primary tumor, as well as nodal and distant metastasis, the TNM staging system is the overall most reliable prognostic factor for cancers. Node metastasis has been shown to be a major prognostic factor for esophageal cancer [6]. Despite recent medical advances, according to the nationwide population-based study of Taiwan, the five-year overall survival for stage II esophageal cancer was only about 28% [2]. Information in reliable prognostic and predictive factors is urgently needed in early, non-metastatic esophageal cancer
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