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Predictions of Pathological Features and Recurrence Based on FDG-PET Findings of Esophageal Squamous Cell Carcinoma after Trimodal Therapy

  • Thoracic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

The degree of metabolic activity in tumor cells can be determined by 18F-fluorodeoxyglucose-positron emission tomography (FDG-PET). Associations between FDG uptake by primary tumors of locally advanced esophageal squamous cell carcinoma (ESCC) under trimodal therapy and the pathological features of such tumors have not been fully investigated.

Patients and Methods

We evaluated relationships between the maximal standardized uptake (SUVmax) in primary tumors on preoperative PET images and pathological features as well as cancer recurrence in 143 patients with ESCC who underwent neoadjuvant chemoradiotherapy (NCRT) followed by surgery.

Results

The post-SUVmax significantly differed after NCRT for ypT and ypN status, lymphatic invasion (LI), venous invasion (VI), and recurrence. Furthermore, the %ΔSUVmax (rate of decrease between before and after NCRT) for LI, VI, and recurrence significantly differed. Univariate and multivariate analyses selected post-SUVmax and %ΔSUVmax as independent preoperative predictors of recurrence-free survival [hazard ratio (HR) 1.46; 95% confidence interval (CI) 1.24–1.72 and HR 0.97; 95% CI 0.96–0.99, respectively; p < 0.001 for both]. Recurrence-free and overall survival were significantly stratified according to optimal SUVmax cutoffs for predicting recurrence (post- and %ΔSUVmax: 2.8 and 70, respectively).

Conclusions

The post- and %ΔSUVmax of primary tumors were significantly associated with the pathological features and recurrence of ESCC under trimodal therapy. Therefore, FDG-PET can preoperatively predict the degree of aggressive tumor behavior in ESCC under trimodal therapy.

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Authors and Affiliations

  1. Department of Surgical Oncology, Hiroshima University, Hiroshima, Japan

    Yoichi Hamai MD, PhD, Manabu Emi MD, PhD, Yuta Ibuki MD, Takaoki Furukawa MD, PhD, Tomoaki Kurokawa MD, Manato Ohsawa MD, Toru Yoshikawa MD & Morihito Okada MD, PhD

  2. Department of Radiation Oncology, Hiroshima University, Hiroshima, Japan

    Yuji Murakami MD, PhD, Ikuno Nishibuchi MD, PhD & Yasushi Nagata MD, PhD

Authors
  1. Yoichi Hamai MD, PhD
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  2. Manabu Emi MD, PhD
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  3. Yuta Ibuki MD
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  4. Yuji Murakami MD, PhD
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  5. Ikuno Nishibuchi MD, PhD
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  6. Yasushi Nagata MD, PhD
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  7. Takaoki Furukawa MD, PhD
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  8. Tomoaki Kurokawa MD
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  9. Manato Ohsawa MD
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  10. Toru Yoshikawa MD
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  11. Morihito Okada MD, PhD
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Correspondence to Yoichi Hamai MD, PhD.

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Hamai, Y., Emi, M., Ibuki, Y. et al. Predictions of Pathological Features and Recurrence Based on FDG-PET Findings of Esophageal Squamous Cell Carcinoma after Trimodal Therapy. Ann Surg Oncol 27, 4422–4430 (2020). https://doi.org/10.1245/s10434-020-08609-0

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  • DOI: https://doi.org/10.1245/s10434-020-08609-0

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