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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 12/2016

01-11-2016 | Thoracic Oncology

Clinical Significance of FDG-PET to Predict Pathologic Tumor Invasion and Lymph Node Metastasis of Superficial Esophageal Squamous Cell Carcinoma

Authors: Takaoki Furukawa, MD, PhD, Yoichi Hamai, MD, PhD, Jun Hihara, MD, PhD, Manabu Emi, MD, PhD, Ichiko Yamakita, MD, Yuta Ibuki, MD, Morihito Okada, MD, PhD

Published in: Annals of Surgical Oncology | Issue 12/2016

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Abstract

Purpose

To determine the preoperative ability of [18F]-fluoro-2-deoxyglucose positron emission tomography (FDG-PET) to predict pathologic tumor invasion and lymph node status in cT1N0M0 esophageal squamous cell carcinoma (ESCC).

Methods

We retrospectively analyzed 40 consecutive patients diagnosed with cT1N0M0 ESCC between February 2006 and April 2011. All patients were treated by esophagectomy with two- or three-field lymphadenectomy without neoadjuvant therapy. We evaluated the relevance between clinical variables including maximum standardized uptake values (SUVmax) of the primary tumor on FDG-PET and pathologic tumor invasion and lymph node status using a logistic regression model.

Results

Tumors invaded the middle submucosal layer (SM2) and beyond in 21 (52.5 %) patients, and 6 (15 %) had lymph node metastases. The areas under receiver operating characteristic (ROC) curves for SUVmax of the primary tumor used to predict factors involved in tumor infiltration to SM2 or deeper and lymph node metastasis were 0.75 (p = 0.006) and 0.79 (p = 0.025), respectively. The optimal SUVmax cutoff was 2.7. The findings of univariate and multivariate analyses identified SUVmax as the only significant preoperative predictor associated with tumor infiltration into SM2 or beyond and lymph node metastasis. Furthermore, SUVmax ≥ 2.7 of the primary tumor on FDG-PET was associated with poor recurrence-free and disease-specific survival (p = 0.019 and p = 0.012, respectively).

Conclusions

FDG-PET is helpful for diagnosing tumors that can infiltrate SM2 and beyond as well as occult lymph node metastasis of cT1N0M0 ESCC that are valuable indications in deciding therapeutic strategies for superficial ESCC.
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Metadata
Title
Clinical Significance of FDG-PET to Predict Pathologic Tumor Invasion and Lymph Node Metastasis of Superficial Esophageal Squamous Cell Carcinoma
Authors
Takaoki Furukawa, MD, PhD
Yoichi Hamai, MD, PhD
Jun Hihara, MD, PhD
Manabu Emi, MD, PhD
Ichiko Yamakita, MD
Yuta Ibuki, MD
Morihito Okada, MD, PhD
Publication date
01-11-2016
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 12/2016
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-016-5359-0

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