Post-treatment/pre-operative PET response is not an independent predictor of outcomes for patients with gastric and GEJ adenocarcinoma Journal Article


Authors: Hernandez, J. M.; Beylergil, V.; Goldman, D. A.; van Beek, E.; Gonen, M.; Tang, L.; Downey, R.; Rizk, N.; Shah, M.; Strong, V.; Janjigian, Y.; Schöder, H.; Coit, D. G.
Article Title: Post-treatment/pre-operative PET response is not an independent predictor of outcomes for patients with gastric and GEJ adenocarcinoma
Abstract: Objective: To determine whether changes in positron emission tomography (PET) avidity correlated with histologic response and were independently associated with outcome. Background: The implications of metabolic response to neoadjuvant therapy as measured by repeat PET imaging remain ill-defined for patients with gastric and gastroesophageal junction (GEJ) cancers. Methods: We identified patients with gastric and GEJ adenocarcinoma who were evaluated with PET imaging before and following neoadjuvant treatment, and subsequently underwent curative resections. Spearman rank correlation and Cox proportional hazards regression were used to evaluate standardized uptake value (SUV) and histologic response, pathologic parameters, and disease-specific survival (DSS). Results: From 2002 to 2013, 192 patients met our inclusion criteria. The median SUV max response was 57.3% (range: -110% to 100%) for patients with GEJ cancers, with a corresponding median pathologic treatment response of 80% (range: 0% to 100%). The median SUV max response was 32.5% (-230% to 100%) for patients with gastric cancers, with a corresponding median pathologic treatment response of 35% (range: 0% to 100%). The Spearman correlation between SUV max response and histologic response was significant for patients with GEJ (rho = 0.19, P = 0.04) and gastric (rho = 0.44, P < 0.0001) cancers. For patients with GEJ (P <0.0001 to 0.046) and gastric cancers (P = 0.0003 to 0.016), histopathologic response and tumor staging predicted DSS. SUV max response failed to demonstrate a relationship with DSS when entered into multivariable models containing conventional pathologic variables. Conclusion: Following completion of neoadjuvant therapy for gastric and GEJ adenocarcinoma, histopathologic staging remains the best predictor of outcome. Repeat post-treatment/preoperative PET imaging for the purpose of prognostication is of limited value. © 2017 Wolters Kluwer Health, Inc. All rights reserved.
Keywords: pet; gastric cancer; gastroesophageal junction cancer
Journal Title: Annals of Surgery
Volume: 267
Issue: 5
ISSN: 0003-4932
Publisher: Lippincott Williams & Wilkins  
Date Published: 2018-05-01
Start Page: 898
End Page: 904
Language: English
DOI: 10.1097/sla.0000000000002306
PROVIDER: scopus
PMCID: PMC5794647
PUBMED: 28767564
DOI/URL:
Notes: Article -- Export Date: 1 May 2018 -- Source: Scopus
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MSK Authors
  1. Nabil Rizk
    134 Rizk
  2. Mithat Gonen
    716 Gonen
  3. Heiko Schoder
    289 Schoder
  4. Yelena Yuriy Janjigian
    148 Janjigian
  5. Manish Shah
    175 Shah
  6. Laura Hong Tang
    328 Tang
  7. Vivian Strong
    148 Strong
  8. Daniel Coit
    422 Coit
  9. Robert J Downey
    203 Downey
  10. Debra Alyssa Goldman
    97 Goldman