Prognostic value of volumetric PET parameters in unresectable and metastatic esophageal cancer

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• 作者：Dietmar Tamandl^a ; ^{dietmar.tamandl@meduniwien.ac.at" class="auth_mail" title="E-mail the corresponding author} ; Julie Ta^a ; Rainer Schmid^b ; Matthias Preusser^c ; Matthias Paireder^d ; Sebastian F. Schoppmann^d ; Alexander Haug^a ; Ahmed Ba-Ssalamah^a
• 关键词：AC ; adenocarcinoma ; AEG ; adenocarcinoma of the the esophago-gastric junction ; CI ; confidence interval ; EC ; esophageal cancer ; ESCC ; esophageal squamous cell carcinoma ; Gy ; gray ; HR ; hazard ratio ; IQR ; interquartile range ; MTV ; metabolic tumor volume ; PET ; positron emission tomography ; RCHT ; radiochemotherapy ; TL ; tumor length ; TLG ; total lesion glycolysis ; SUV ; standardized uptake value
• 刊名：European Journal of Radiology
• 出版年：2016
• 出版时间：March 2016
• 年：2016
• 卷：85
• 期：3
• 页码：540-545
• 全文大小：1007 K

文摘

To assess the prognostic value of volumetric parameters measured with PET/CT in patients with advanced or metastatic esophageal cancer (EC).

Materials and methods

We identified 71 patients (33 adenocarcinoma [AC] and 38 squamous cell carcinoma [ESCC]) with unresectable or metastatic EC who had PET/CT prior to palliative treatment. Volumetric parameters (metabolic tumor volume [MTV], total lesion glycolysis [TLG], tumor length [TL]) as well as maximum and mean standardized uptake (SUVmax, SUVmean) were obtained from ¹⁸F-FDG PET/CT studies. The correlation between overall survival (OS) and established clinical parameters was assessed using a Cox proportional hazards model.

Results

ESCC patients had higher SUVmax and SUVmean compared to AC (p = 0.002 and p < 0.001, respectively). There was an association of lower SUVmax and SUVmean with metastatic compared to locally advanced tumors (e.g., median SUVmax stage IV: 14.9, 95% confidence interval [95% CI 4.4–35.5] vs. stage IIIA-C: 23.3 [9.2–40.6], p = 0.017). TL, MTV and TLG showed an association to OS for all patients and for the subgroup of AC patients (AC; TL: Hazard ratio [HR] 3.23, [95% CI 1.03–10.11], p = 0.044; MTV: HR 3.16, [95% CI 1.08-9.23], p = 0.035). There was no correlation between PET parameters and survival in ESCC patients. Clinical nodal status was the only clinical variable associated to OS (HR 2.45 [95% CI 1.26–4.75], p = 0.008) in AC patients. In a multivariate analysis, nodal status and MTV remained as independent factors associated to OS (N: HR 9.98, [95% CI 1.28–78.11], p = 0.028; MTV: HR 1.02, [95% CI 1.01–1.03], p = 0.003).

Conclusions

MTV predicted poor OS in patients with advanced AC. No PET parameters were associated to OS in ESCC patients.