Predictive value of initial PET-SUV(max) in patients with locally advanced esophageal and gastroesophageal junction adenocarcinoma Journal Article


Authors: Rizk, N. P.; Tang, L.; Adusumilli, P. S.; Bains, M. S.; Akhurst, T. J.; Ilson, D.; Goodman, K.; Rusch, V. W.
Article Title: Predictive value of initial PET-SUV(max) in patients with locally advanced esophageal and gastroesophageal junction adenocarcinoma
Abstract: Introduction: We have previously shown that in early clinical stage esophageal adenocarcinoma, a positron emission tomography standardized uptake values (PET SUV(max)) of <4.5 is associated with earlier pathologic stage and predicts better survival.In this study, we analyze the impact of the pretreatment PET SUV(max) in patients with locally advanced esophageal adenocarcinoma who undergo preoperative chemoradiotherapy. Methods: We performed a retrospective analysis, selecting patients with adenocarcinoma of the esophagus who had a pretreatment PET scan and who received chemoradiotherapy before esophagectomy. Data recorded included demographics, PET SUV (max), treatment details, pathologic details, and survival data. Comparison of categorical variables was done by X(2) analysis, continuous variables by t test, survival analysis by the Kaplan-Meier method, and comparisons of survival using the log-rank test. Results: Between January 1996 and September 2007, 189 patients were appropriate for this analysis. The init al PET SUV(max) was <4.5 in 28 patients and ≥4.5 in 161 patients. The two groups were similar with regards to demographics and treatment details. Patients in the low SUV group were less likely to show evidence of treatment response after chemoradiotherapy, including a higher likelihood of residual nodal disease and a lower likelihood of a pathologic complete response and estimated treatment response. However, both groups had similar survival. Conclusions: Although the initial PET SUV(max) does not predict survival in patients with locally advanced esophageal adenocarcinoma who receive preoperative chemoradiotherapy, patients with a high initial SUV(max) respond better to preoperative therapy. These results can be used to better select esophageal cancer patients for combined modality treatment. © 2009 by the International Association for the Study of Lung Cancer.
Keywords: adult; cancer survival; treatment response; middle aged; survival rate; retrospective studies; major clinical study; cancer localization; cisplatin; advanced cancer; patient selection; comparative study; preoperative care; positron emission tomography; radiopharmaceuticals; adenocarcinoma; demography; retrospective study; whole body imaging; fluorodeoxyglucose f 18; fluorodeoxyglucose f18; predictive value of tests; esophagus resection; predictor variable; chi-square distribution; therapy effect; esophageal adenocarcinoma; esophageal neoplasms; pet scan; lower esophagus sphincter; esophagus adenocarcinoma; preoperative chemoradiotherapy; whole body pet; esophagogastric junction
Journal Title: Journal of Thoracic Oncology
Volume: 4
Issue: 7
ISSN: 1556-0864
Publisher: Elsevier Inc.  
Date Published: 2009-07-01
Start Page: 875
End Page: 879
Language: English
DOI: 10.1097/JTO.0b013e3181a8cebf
PUBMED: 19487968
PROVIDER: scopus
DOI/URL:
Notes: --- - "Export Date: 30 November 2010" - "Source: Scopus"
Altmetric
Citation Impact
BMJ Impact Analytics
MSK Authors
  1. Valerie W Rusch
    869 Rusch
  2. Karyn A Goodman
    257 Goodman
  3. Nabil Rizk
    139 Rizk
  4. Timothy J Akhurst
    139 Akhurst
  5. Laura Hong Tang
    448 Tang
  6. David H Ilson
    436 Ilson
  7. Manjit S Bains
    339 Bains