Value of the primary tumor initial standardized uptake value (iSUV) of 18F-fluorodeoxyglucose positron emission tomography (PET) to predict overall survival (OS) in patients with esophageal or gastroesophageal junction carcinoma undergoing definitive chemoradiotherapy.

Abstract

82 Background: The value of iSUV of PET for predicting OS is unclear in patients with advanced esophageal or gastroesophageal carcinoma treated with definitive chemoradiotherapy. We tested the hypothesis that iSUV would correlate with OS and recurrence free survival (RFS). Methods: We performed retrospective analysis, selecting patients with esophageal or gastroesophageal carcinoma who had a pretreatment PET and endoscopic ultrasonography (EUS) and who received definitive chemoradiotherapy from 2002 to 2008. Correlations were performed with continuous and dichotomized iSUV, baseline EUS results, OS, and RFS. Results: Two hundred and nine patients were analyzed. The median OS time was 20.7 months (95% CI: 18.8-26.3 months) and the median RFS time was 11.2 months (95% CI: 9.44, 14.34). OS rate and RFS rate at 3 years were 35.7% (95% CI: 29.0-43.9%) and 24.8% (95 % CI: 19.1–32.1 %). The median iSUV was 12.7 (range: 0–51). In univariate analysis, iSUV was associated with OS (Cox model, P = 0.012; log-rank test, P = 0.002) and RFS (Cox model, P = 0.0003; log-rank test, P < 0.0001). In multivariate analysis, dichotomized iSUV cut off by median was associated with OS (P = 0.024) but not RFS (P = 0.11). Conclusions: Data from our study suggests that higher iSUV is associated with poor survival. Baseline PET may become a useful stratification factor in randomized trials and for individualized therapy. No significant financial relationships to disclose.