Published in:
01-12-2009 | Original Article
Does the Value of PET-CT Extend Beyond Pretreatment Staging? An Analysis of Survival in Surgical Patients with Esophageal Cancer
Authors:
Boris Sepesi, Daniel P. Raymond, Marek Polomsky, Thomas J. Watson, Virginia R. Litle, Carolyn E. Jones, Rui Hu, Xing Qiu, Jeffrey H. Peters
Published in:
Journal of Gastrointestinal Surgery
|
Issue 12/2009
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Abstract
Background
Studies of positron emission tomography (PET) have focused mainly on tumor staging. The role of PET in predicting survival has received less attention. We sought to assess the relationship of pretreatment maximum standard uptake value (SUVmax) to survival in surgical patients with esophageal cancer.
Methods
The study consisted of 72 esophagectomy patients (60 with adenocarcinoma) undergoing resection between July 2005 and April 2009. PET combined with computed tomography (PET-CT) was performed at a single center, and SUVmax was recorded prior to any therapy. Survival was assessed at a median follow-up of 19 months.
Results
The median SUVmax was 6.25. A receiver operating characteristic curve identified SUVmax 4.5 to optimally discriminate survival. Patients with low SUVmax (<4.5) had significantly (p = 0.0003) better survival than those with high SUVmax (≥4.5). Stage 3 patients with low SUVmax had significantly better survival (p = 0.0069) than those with high SUVmax. Likewise, N1 disease patients with low SUVmax had significantly better survival (p = 0.008) than those with high SUVmax. Multivariate analysis identified SUVmax to be an independent predictor of survival (p = 0.0021).
Conclusion
Pretreatment PET-CT SUVmax independently predicts survival in patients with esophageal carcinoma undergoing resection. SUVmax may be a valuable marker of tumor biology that could potentially be exploited for prognostic and therapeutic purposes.