Preoperative 18[F]-fluorodeoxyglucose positron emission tomography standardized uptake values predict survival after esophageal adenocarcinoma resection Journal Article


Authors: Rizk, N.; Downey, R. J.; Akhurst, T.; Gonen, M.; Bains, M. S.; Larson, S.; Rusch, V.
Article Title: Preoperative 18[F]-fluorodeoxyglucose positron emission tomography standardized uptake values predict survival after esophageal adenocarcinoma resection
Abstract: Background. Clinical staging modalities for esophageal cancer are inaccurate at determining prognosis, especially in early-stage patients. We performed a retrospective review of patients with esophageal adenocarcinoma imaged by positron emission tomography before surgical resection to determine whether 18[F]-fluorodeoxyglucose uptake predicted overall survival independently of clinical and pathologic stage. Methods. The study is a retrospective review of patients with adenocarcinoma of the esophagus treated by surgery. All patients were imaged with computed tomography and positron emission tomography imaging, and most patients had an endoscopic ultrasound. We compared positron emission tomography standardized uptake values (SUV max) with clinical and pathologic stage and survival. Prognostic variables were assessed by log-rank test, and survival by the method of Kaplan and Meier. Results. From January 1996 through June 2004, 50 patients meeting study eligibility criteria were analyzed. Median follow-up for surviving patients was 27 months. The median SUVmax was 4.5. Stratification of patients by the median SUVmax predicted survival. The 3-year survival was 57% for patients with an SUVmax greater than 4.5 and 95% for patients with an SUVmax of 4.5 or less (p = 0.02). The survival advantage of the SUVmax 4.5 or less group was also seen in clinically early-stage patients (defined as no adenopathy on computed tomography and positron emission tomography, and by endoscopic ultrasound T1-2 N0), as well as in patients with pathologically early-stage disease (T-2 N0). Conclusions. In surgically managed esophageal adenocarcinoma patients, SUVmax predicts overall survival. Moreover, SUVmax identifies patients who have a poor prognosis from a subset of patients that would otherwise be considered to have early-stage disease. © 2006 by The Society of Thoracic Surgeons.
Keywords: cancer survival; controlled study; aged; survival analysis; retrospective studies; major clinical study; review; positron emission tomography; follow up; follow-up studies; neoplasm staging; sensitivity and specificity; radiopharmaceuticals; adenocarcinoma; computer assisted tomography; clinical assessment; tomography, x-ray computed; pathology; diagnostic imaging; medical record review; ultrasound; standard; disease severity; preoperative period; drug uptake; fluorodeoxyglucose f 18; fluorodeoxyglucose f18; positron-emission tomography; prediction and forecasting; predictive value of tests; gastrectomy; kaplan meier method; esophageal adenocarcinoma; endoscopy; lymphadenopathy; biological transport; esophageal neoplasms; log rank test; stratification
Journal Title: Annals of Thoracic Surgery
Volume: 81
Issue: 3
ISSN: 0003-4975
Publisher: Elsevier Science, Inc.  
Date Published: 2006-03-01
Start Page: 1076
End Page: 1081
Language: English
DOI: 10.1016/j.athoracsur.2005.09.063
PUBMED: 16488726
PROVIDER: scopus
DOI/URL:
Notes: --- - "Cited By (since 1996): 57" - "Export Date: 4 June 2012" - "CODEN: ATHSA" - "Source: Scopus"
Altmetric Score
MSK Authors
  1. Valerie W Rusch
    657 Rusch
  2. Nabil Rizk
    134 Rizk
  3. Mithat Gonen
    716 Gonen
  4. Timothy J Akhurst
    134 Akhurst
  5. Robert J Downey
    203 Downey
  6. Steven M Larson
    778 Larson
  7. Manjit S Bains
    229 Bains