2‐Fluoro‐2‐deoxy‐D‐glucose positron emission tomography imaging is predictive of pathologic response and survival after preoperative chemoradiation in patients with esophageal carcinoma
BACKGROUND The current study was performed to assess the value of 2‐fluoro‐2‐deoxy‐d‐glucose positron emission tomography (FDG‐PET) in predicting the pathologic response and survival of patients with esophageal carcinoma treated with preoperative chemoradiation (CRT) and tumor resection. Preliminary...
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| Veröffentlicht in: | Cancer 2004-10, Vol.101 (8), p.1776-1785 |
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| creator | Swisher, Stephen G. Erasmus, Jeremy Maish, Mary Correa, Arlene M. Macapinlac, Homer Ajani, Jaffer A. Cox, James D. Komaki, Ritsuko R. Hong, David Lee, Hoon K. Putnam, Joe B. Rice, David C. Smythe, W. Roy Thai, Linh Vaporciyan, Ara A. Walsh, Garrett L. Wu, Tsung‐Teh Roth, Jack A. |
| description | BACKGROUND
The current study was performed to assess the value of 2‐fluoro‐2‐deoxy‐d‐glucose positron emission tomography (FDG‐PET) in predicting the pathologic response and survival of patients with esophageal carcinoma treated with preoperative chemoradiation (CRT) and tumor resection. Preliminary reports suggest that FDG‐PET may be predictive of the response of esophageal carcinoma patients to preoperative CRT.
METHODS
Eighty‐three patients with resectable esophageal carcinoma who underwent preoperative CRT and FDG‐PET and tumor resection were evaluated for pathologic response to CRT, percent residual tumor, and survival.
RESULTS
The majority of patients in the current study were men (74 of 83 patients; 89%). Most tumors were adenocarcinomas (73 of 83 tumors; 88%) and clinical EUST3/4 (69 tumors; 83%) or N1 (46 tumors; 55%). FDG‐PET after preoperative CRT identified pathologic responders but failed to rule out microscopic residual tumor in 13 of 73 cases (18%). Pathologic response was found to correlate with the post‐CRT FDG‐PET standardized uptake value (SUV) (P = 0.03) and a post‐CRT FDG‐PET SUV of ≥ 4 was found to be the only preoperative factor to correlate with decreased survival (2‐year survival rate of 33% vs. 60%; P = 0.01). On univariate Cox regression analysis, only post‐CRT FDG‐PET was found to be correlated with post‐CRT survival (P = 0.04).
CONCLUSIONS
Post‐CRT FDG‐PET was found to be predictive of pathologic response and survival in patients with esophageal carcinoma who undergo preoperative CRT. Esophagectomy should still be considered even if the post‐CRT FDG‐PET scan is normal because microscopic residual disease cannot be ruled out. Cancer 2004. © 2004 American Cancer Society.
2‐fluoro‐2‐deoxy‐d‐glucose positron emission tomography (FDG‐PET) imaging after preoperative chemoradiation therapy (CRT) and before resection appears to be predictive of pathologic response, tumor viability, and overall survival in patients with esophageal carcinoma. However, it cannot distinguish between those patients with microscopic residual disease and complete responders. Therefore, esophagectomy remains a therapeutic option, even if the post‐CRT FDG‐PET scan is normal. |
| doi_str_mv | 10.1002/cncr.20585 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_66954879</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>66954879</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3915-ff6cbb65e4270fc0723d65ae03529dc94d7d34afb5c2b5979f18b7978cbeba953</originalsourceid><addsrcrecordid>eNp9kcFu1DAQhi0EokvhwgMgX-CAlGLHcRIf0UIpUgUSAolb5DjjrFHiCXayZW88Au_Em_Akdbor9cZhNDPSN_8vzU_Ic84uOGP5G-NNuMiZrOUDsuFMVRnjRf6QbBhjdSYL8f2MPInxR1qrXIrH5IxLUZdC5BvyN__3-8_lsGDANKxLB_jrkPq7VP2wGIxAJ4xuDugpjC5Gl4YZR-yDnnYH6kbdO99TF-kUoHNmdnugaOmk5x0O2DtDA8QJfVLSvqNxCXu31wPVdoawHuEEQd-dmR2MGHTn0ppsnF9VHPg50hs37yhEnHa6h3RtdDDO46ifkkdWDxGenfo5-Xb5_uv2Krv-_OHj9u11ZoTiMrO2NG1bSijyilmTfiG6UmpgQuaqM6roqk4U2rbS5K1UlbK8bitV1aaFVispzsmro-4U8OcCcW7SNwwMg_aAS2zKUsmirlQCXx9BEzDGALaZQvpSODScNWtkzRpZcxdZgl-cVJd2hO4ePWWUgJcnQEejBxu0Ny7ecyUvalbzxPEjd-MGOPzHstl-2n45mt8CBsy6IQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>66954879</pqid></control><display><type>article</type><title>2‐Fluoro‐2‐deoxy‐D‐glucose positron emission tomography imaging is predictive of pathologic response and survival after preoperative chemoradiation in patients with esophageal carcinoma</title><source>Wiley Free Content</source><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Alma/SFX Local Collection</source><creator>Swisher, Stephen G. ; Erasmus, Jeremy ; Maish, Mary ; Correa, Arlene M. ; Macapinlac, Homer ; Ajani, Jaffer A. ; Cox, James D. ; Komaki, Ritsuko R. ; Hong, David ; Lee, Hoon K. ; Putnam, Joe B. ; Rice, David C. ; Smythe, W. Roy ; Thai, Linh ; Vaporciyan, Ara A. ; Walsh, Garrett L. ; Wu, Tsung‐Teh ; Roth, Jack A.</creator><creatorcontrib>Swisher, Stephen G. ; Erasmus, Jeremy ; Maish, Mary ; Correa, Arlene M. ; Macapinlac, Homer ; Ajani, Jaffer A. ; Cox, James D. ; Komaki, Ritsuko R. ; Hong, David ; Lee, Hoon K. ; Putnam, Joe B. ; Rice, David C. ; Smythe, W. Roy ; Thai, Linh ; Vaporciyan, Ara A. ; Walsh, Garrett L. ; Wu, Tsung‐Teh ; Roth, Jack A.</creatorcontrib><description>BACKGROUND
The current study was performed to assess the value of 2‐fluoro‐2‐deoxy‐d‐glucose positron emission tomography (FDG‐PET) in predicting the pathologic response and survival of patients with esophageal carcinoma treated with preoperative chemoradiation (CRT) and tumor resection. Preliminary reports suggest that FDG‐PET may be predictive of the response of esophageal carcinoma patients to preoperative CRT.
METHODS
Eighty‐three patients with resectable esophageal carcinoma who underwent preoperative CRT and FDG‐PET and tumor resection were evaluated for pathologic response to CRT, percent residual tumor, and survival.
RESULTS
The majority of patients in the current study were men (74 of 83 patients; 89%). Most tumors were adenocarcinomas (73 of 83 tumors; 88%) and clinical EUST3/4 (69 tumors; 83%) or N1 (46 tumors; 55%). FDG‐PET after preoperative CRT identified pathologic responders but failed to rule out microscopic residual tumor in 13 of 73 cases (18%). Pathologic response was found to correlate with the post‐CRT FDG‐PET standardized uptake value (SUV) (P = 0.03) and a post‐CRT FDG‐PET SUV of ≥ 4 was found to be the only preoperative factor to correlate with decreased survival (2‐year survival rate of 33% vs. 60%; P = 0.01). On univariate Cox regression analysis, only post‐CRT FDG‐PET was found to be correlated with post‐CRT survival (P = 0.04).
CONCLUSIONS
Post‐CRT FDG‐PET was found to be predictive of pathologic response and survival in patients with esophageal carcinoma who undergo preoperative CRT. Esophagectomy should still be considered even if the post‐CRT FDG‐PET scan is normal because microscopic residual disease cannot be ruled out. Cancer 2004. © 2004 American Cancer Society.
2‐fluoro‐2‐deoxy‐d‐glucose positron emission tomography (FDG‐PET) imaging after preoperative chemoradiation therapy (CRT) and before resection appears to be predictive of pathologic response, tumor viability, and overall survival in patients with esophageal carcinoma. However, it cannot distinguish between those patients with microscopic residual disease and complete responders. Therefore, esophagectomy remains a therapeutic option, even if the post‐CRT FDG‐PET scan is normal.</description><identifier>ISSN: 0008-543X</identifier><identifier>EISSN: 1097-0142</identifier><identifier>DOI: 10.1002/cncr.20585</identifier><identifier>PMID: 15386332</identifier><identifier>CODEN: CANCAR</identifier><language>eng</language><publisher>Hoboken: Wiley Subscription Services, Inc., A Wiley Company</publisher><subject>2‐fluoro‐2‐deoxy‐d‐glucose positron emission tomography (FDG‐PET) ; Adenocarcinoma - diagnostic imaging ; Adenocarcinoma - pathology ; Adenocarcinoma - therapy ; Adult ; Aged ; Biological and medical sciences ; Carcinoma, Squamous Cell - diagnostic imaging ; Carcinoma, Squamous Cell - pathology ; Carcinoma, Squamous Cell - therapy ; Combined Modality Therapy ; esophageal carcinoma ; Esophageal Neoplasms - diagnostic imaging ; Esophageal Neoplasms - pathology ; Esophageal Neoplasms - therapy ; Female ; Fluorodeoxyglucose F18 ; Humans ; Male ; Medical sciences ; Middle Aged ; Neoplasm Staging ; Predictive Value of Tests ; Preoperative Care ; preoperative chemoradiation (CRT) ; Prognosis ; Radiopharmaceuticals ; Remission Induction ; Retrospective Studies ; Risk Factors ; Sensitivity and Specificity ; survival ; Survival Rate ; Tomography, Emission-Computed ; Tumors</subject><ispartof>Cancer, 2004-10, Vol.101 (8), p.1776-1785</ispartof><rights>Copyright © 2004 American Cancer Society</rights><rights>2004 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3915-ff6cbb65e4270fc0723d65ae03529dc94d7d34afb5c2b5979f18b7978cbeba953</citedby><cites>FETCH-LOGICAL-c3915-ff6cbb65e4270fc0723d65ae03529dc94d7d34afb5c2b5979f18b7978cbeba953</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fcncr.20585$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fcncr.20585$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,1427,27901,27902,45550,45551,46384,46808</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=16148081$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15386332$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Swisher, Stephen G.</creatorcontrib><creatorcontrib>Erasmus, Jeremy</creatorcontrib><creatorcontrib>Maish, Mary</creatorcontrib><creatorcontrib>Correa, Arlene M.</creatorcontrib><creatorcontrib>Macapinlac, Homer</creatorcontrib><creatorcontrib>Ajani, Jaffer A.</creatorcontrib><creatorcontrib>Cox, James D.</creatorcontrib><creatorcontrib>Komaki, Ritsuko R.</creatorcontrib><creatorcontrib>Hong, David</creatorcontrib><creatorcontrib>Lee, Hoon K.</creatorcontrib><creatorcontrib>Putnam, Joe B.</creatorcontrib><creatorcontrib>Rice, David C.</creatorcontrib><creatorcontrib>Smythe, W. Roy</creatorcontrib><creatorcontrib>Thai, Linh</creatorcontrib><creatorcontrib>Vaporciyan, Ara A.</creatorcontrib><creatorcontrib>Walsh, Garrett L.</creatorcontrib><creatorcontrib>Wu, Tsung‐Teh</creatorcontrib><creatorcontrib>Roth, Jack A.</creatorcontrib><title>2‐Fluoro‐2‐deoxy‐D‐glucose positron emission tomography imaging is predictive of pathologic response and survival after preoperative chemoradiation in patients with esophageal carcinoma</title><title>Cancer</title><addtitle>Cancer</addtitle><description>BACKGROUND
The current study was performed to assess the value of 2‐fluoro‐2‐deoxy‐d‐glucose positron emission tomography (FDG‐PET) in predicting the pathologic response and survival of patients with esophageal carcinoma treated with preoperative chemoradiation (CRT) and tumor resection. Preliminary reports suggest that FDG‐PET may be predictive of the response of esophageal carcinoma patients to preoperative CRT.
METHODS
Eighty‐three patients with resectable esophageal carcinoma who underwent preoperative CRT and FDG‐PET and tumor resection were evaluated for pathologic response to CRT, percent residual tumor, and survival.
RESULTS
The majority of patients in the current study were men (74 of 83 patients; 89%). Most tumors were adenocarcinomas (73 of 83 tumors; 88%) and clinical EUST3/4 (69 tumors; 83%) or N1 (46 tumors; 55%). FDG‐PET after preoperative CRT identified pathologic responders but failed to rule out microscopic residual tumor in 13 of 73 cases (18%). Pathologic response was found to correlate with the post‐CRT FDG‐PET standardized uptake value (SUV) (P = 0.03) and a post‐CRT FDG‐PET SUV of ≥ 4 was found to be the only preoperative factor to correlate with decreased survival (2‐year survival rate of 33% vs. 60%; P = 0.01). On univariate Cox regression analysis, only post‐CRT FDG‐PET was found to be correlated with post‐CRT survival (P = 0.04).
CONCLUSIONS
Post‐CRT FDG‐PET was found to be predictive of pathologic response and survival in patients with esophageal carcinoma who undergo preoperative CRT. Esophagectomy should still be considered even if the post‐CRT FDG‐PET scan is normal because microscopic residual disease cannot be ruled out. Cancer 2004. © 2004 American Cancer Society.
2‐fluoro‐2‐deoxy‐d‐glucose positron emission tomography (FDG‐PET) imaging after preoperative chemoradiation therapy (CRT) and before resection appears to be predictive of pathologic response, tumor viability, and overall survival in patients with esophageal carcinoma. However, it cannot distinguish between those patients with microscopic residual disease and complete responders. Therefore, esophagectomy remains a therapeutic option, even if the post‐CRT FDG‐PET scan is normal.</description><subject>2‐fluoro‐2‐deoxy‐d‐glucose positron emission tomography (FDG‐PET)</subject><subject>Adenocarcinoma - diagnostic imaging</subject><subject>Adenocarcinoma - pathology</subject><subject>Adenocarcinoma - therapy</subject><subject>Adult</subject><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Carcinoma, Squamous Cell - diagnostic imaging</subject><subject>Carcinoma, Squamous Cell - pathology</subject><subject>Carcinoma, Squamous Cell - therapy</subject><subject>Combined Modality Therapy</subject><subject>esophageal carcinoma</subject><subject>Esophageal Neoplasms - diagnostic imaging</subject><subject>Esophageal Neoplasms - pathology</subject><subject>Esophageal Neoplasms - therapy</subject><subject>Female</subject><subject>Fluorodeoxyglucose F18</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Neoplasm Staging</subject><subject>Predictive Value of Tests</subject><subject>Preoperative Care</subject><subject>preoperative chemoradiation (CRT)</subject><subject>Prognosis</subject><subject>Radiopharmaceuticals</subject><subject>Remission Induction</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Sensitivity and Specificity</subject><subject>survival</subject><subject>Survival Rate</subject><subject>Tomography, Emission-Computed</subject><subject>Tumors</subject><issn>0008-543X</issn><issn>1097-0142</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2004</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kcFu1DAQhi0EokvhwgMgX-CAlGLHcRIf0UIpUgUSAolb5DjjrFHiCXayZW88Au_Em_Akdbor9cZhNDPSN_8vzU_Ic84uOGP5G-NNuMiZrOUDsuFMVRnjRf6QbBhjdSYL8f2MPInxR1qrXIrH5IxLUZdC5BvyN__3-8_lsGDANKxLB_jrkPq7VP2wGIxAJ4xuDugpjC5Gl4YZR-yDnnYH6kbdO99TF-kUoHNmdnugaOmk5x0O2DtDA8QJfVLSvqNxCXu31wPVdoawHuEEQd-dmR2MGHTn0ppsnF9VHPg50hs37yhEnHa6h3RtdDDO46ifkkdWDxGenfo5-Xb5_uv2Krv-_OHj9u11ZoTiMrO2NG1bSijyilmTfiG6UmpgQuaqM6roqk4U2rbS5K1UlbK8bitV1aaFVispzsmro-4U8OcCcW7SNwwMg_aAS2zKUsmirlQCXx9BEzDGALaZQvpSODScNWtkzRpZcxdZgl-cVJd2hO4ePWWUgJcnQEejBxu0Ny7ecyUvalbzxPEjd-MGOPzHstl-2n45mt8CBsy6IQ</recordid><startdate>20041015</startdate><enddate>20041015</enddate><creator>Swisher, Stephen G.</creator><creator>Erasmus, Jeremy</creator><creator>Maish, Mary</creator><creator>Correa, Arlene M.</creator><creator>Macapinlac, Homer</creator><creator>Ajani, Jaffer A.</creator><creator>Cox, James D.</creator><creator>Komaki, Ritsuko R.</creator><creator>Hong, David</creator><creator>Lee, Hoon K.</creator><creator>Putnam, Joe B.</creator><creator>Rice, David C.</creator><creator>Smythe, W. Roy</creator><creator>Thai, Linh</creator><creator>Vaporciyan, Ara A.</creator><creator>Walsh, Garrett L.</creator><creator>Wu, Tsung‐Teh</creator><creator>Roth, Jack A.</creator><general>Wiley Subscription Services, Inc., A Wiley Company</general><general>Wiley-Liss</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20041015</creationdate><title>2‐Fluoro‐2‐deoxy‐D‐glucose positron emission tomography imaging is predictive of pathologic response and survival after preoperative chemoradiation in patients with esophageal carcinoma</title><author>Swisher, Stephen G. ; Erasmus, Jeremy ; Maish, Mary ; Correa, Arlene M. ; Macapinlac, Homer ; Ajani, Jaffer A. ; Cox, James D. ; Komaki, Ritsuko R. ; Hong, David ; Lee, Hoon K. ; Putnam, Joe B. ; Rice, David C. ; Smythe, W. Roy ; Thai, Linh ; Vaporciyan, Ara A. ; Walsh, Garrett L. ; Wu, Tsung‐Teh ; Roth, Jack A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3915-ff6cbb65e4270fc0723d65ae03529dc94d7d34afb5c2b5979f18b7978cbeba953</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2004</creationdate><topic>2‐fluoro‐2‐deoxy‐d‐glucose positron emission tomography (FDG‐PET)</topic><topic>Adenocarcinoma - diagnostic imaging</topic><topic>Adenocarcinoma - pathology</topic><topic>Adenocarcinoma - therapy</topic><topic>Adult</topic><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Carcinoma, Squamous Cell - diagnostic imaging</topic><topic>Carcinoma, Squamous Cell - pathology</topic><topic>Carcinoma, Squamous Cell - therapy</topic><topic>Combined Modality Therapy</topic><topic>esophageal carcinoma</topic><topic>Esophageal Neoplasms - diagnostic imaging</topic><topic>Esophageal Neoplasms - pathology</topic><topic>Esophageal Neoplasms - therapy</topic><topic>Female</topic><topic>Fluorodeoxyglucose F18</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Neoplasm Staging</topic><topic>Predictive Value of Tests</topic><topic>Preoperative Care</topic><topic>preoperative chemoradiation (CRT)</topic><topic>Prognosis</topic><topic>Radiopharmaceuticals</topic><topic>Remission Induction</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Sensitivity and Specificity</topic><topic>survival</topic><topic>Survival Rate</topic><topic>Tomography, Emission-Computed</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Swisher, Stephen G.</creatorcontrib><creatorcontrib>Erasmus, Jeremy</creatorcontrib><creatorcontrib>Maish, Mary</creatorcontrib><creatorcontrib>Correa, Arlene M.</creatorcontrib><creatorcontrib>Macapinlac, Homer</creatorcontrib><creatorcontrib>Ajani, Jaffer A.</creatorcontrib><creatorcontrib>Cox, James D.</creatorcontrib><creatorcontrib>Komaki, Ritsuko R.</creatorcontrib><creatorcontrib>Hong, David</creatorcontrib><creatorcontrib>Lee, Hoon K.</creatorcontrib><creatorcontrib>Putnam, Joe B.</creatorcontrib><creatorcontrib>Rice, David C.</creatorcontrib><creatorcontrib>Smythe, W. Roy</creatorcontrib><creatorcontrib>Thai, Linh</creatorcontrib><creatorcontrib>Vaporciyan, Ara A.</creatorcontrib><creatorcontrib>Walsh, Garrett L.</creatorcontrib><creatorcontrib>Wu, Tsung‐Teh</creatorcontrib><creatorcontrib>Roth, Jack A.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Cancer</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Swisher, Stephen G.</au><au>Erasmus, Jeremy</au><au>Maish, Mary</au><au>Correa, Arlene M.</au><au>Macapinlac, Homer</au><au>Ajani, Jaffer A.</au><au>Cox, James D.</au><au>Komaki, Ritsuko R.</au><au>Hong, David</au><au>Lee, Hoon K.</au><au>Putnam, Joe B.</au><au>Rice, David C.</au><au>Smythe, W. Roy</au><au>Thai, Linh</au><au>Vaporciyan, Ara A.</au><au>Walsh, Garrett L.</au><au>Wu, Tsung‐Teh</au><au>Roth, Jack A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>2‐Fluoro‐2‐deoxy‐D‐glucose positron emission tomography imaging is predictive of pathologic response and survival after preoperative chemoradiation in patients with esophageal carcinoma</atitle><jtitle>Cancer</jtitle><addtitle>Cancer</addtitle><date>2004-10-15</date><risdate>2004</risdate><volume>101</volume><issue>8</issue><spage>1776</spage><epage>1785</epage><pages>1776-1785</pages><issn>0008-543X</issn><eissn>1097-0142</eissn><coden>CANCAR</coden><abstract>BACKGROUND
The current study was performed to assess the value of 2‐fluoro‐2‐deoxy‐d‐glucose positron emission tomography (FDG‐PET) in predicting the pathologic response and survival of patients with esophageal carcinoma treated with preoperative chemoradiation (CRT) and tumor resection. Preliminary reports suggest that FDG‐PET may be predictive of the response of esophageal carcinoma patients to preoperative CRT.
METHODS
Eighty‐three patients with resectable esophageal carcinoma who underwent preoperative CRT and FDG‐PET and tumor resection were evaluated for pathologic response to CRT, percent residual tumor, and survival.
RESULTS
The majority of patients in the current study were men (74 of 83 patients; 89%). Most tumors were adenocarcinomas (73 of 83 tumors; 88%) and clinical EUST3/4 (69 tumors; 83%) or N1 (46 tumors; 55%). FDG‐PET after preoperative CRT identified pathologic responders but failed to rule out microscopic residual tumor in 13 of 73 cases (18%). Pathologic response was found to correlate with the post‐CRT FDG‐PET standardized uptake value (SUV) (P = 0.03) and a post‐CRT FDG‐PET SUV of ≥ 4 was found to be the only preoperative factor to correlate with decreased survival (2‐year survival rate of 33% vs. 60%; P = 0.01). On univariate Cox regression analysis, only post‐CRT FDG‐PET was found to be correlated with post‐CRT survival (P = 0.04).
CONCLUSIONS
Post‐CRT FDG‐PET was found to be predictive of pathologic response and survival in patients with esophageal carcinoma who undergo preoperative CRT. Esophagectomy should still be considered even if the post‐CRT FDG‐PET scan is normal because microscopic residual disease cannot be ruled out. Cancer 2004. © 2004 American Cancer Society.
2‐fluoro‐2‐deoxy‐d‐glucose positron emission tomography (FDG‐PET) imaging after preoperative chemoradiation therapy (CRT) and before resection appears to be predictive of pathologic response, tumor viability, and overall survival in patients with esophageal carcinoma. However, it cannot distinguish between those patients with microscopic residual disease and complete responders. Therefore, esophagectomy remains a therapeutic option, even if the post‐CRT FDG‐PET scan is normal.</abstract><cop>Hoboken</cop><pub>Wiley Subscription Services, Inc., A Wiley Company</pub><pmid>15386332</pmid><doi>10.1002/cncr.20585</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | 2‐fluoro‐2‐deoxy‐d‐glucose positron emission tomography (FDG‐PET) Adenocarcinoma - diagnostic imaging Adenocarcinoma - pathology Adenocarcinoma - therapy Adult Aged Biological and medical sciences Carcinoma, Squamous Cell - diagnostic imaging Carcinoma, Squamous Cell - pathology Carcinoma, Squamous Cell - therapy Combined Modality Therapy esophageal carcinoma Esophageal Neoplasms - diagnostic imaging Esophageal Neoplasms - pathology Esophageal Neoplasms - therapy Female Fluorodeoxyglucose F18 Humans Male Medical sciences Middle Aged Neoplasm Staging Predictive Value of Tests Preoperative Care preoperative chemoradiation (CRT) Prognosis Radiopharmaceuticals Remission Induction Retrospective Studies Risk Factors Sensitivity and Specificity survival Survival Rate Tomography, Emission-Computed Tumors |
| title | 2‐Fluoro‐2‐deoxy‐D‐glucose positron emission tomography imaging is predictive of pathologic response and survival after preoperative chemoradiation in patients with esophageal carcinoma |
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