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Open Access 01-07-2017 | Thoracic Oncology

Impact of Endoscopic Ultrasonography on ¹⁸F-FDG-PET/CT Upfront Towards Patient Specific Esophageal Cancer Treatment

Authors: J. B. Hulshoff, MD, V. E. M. Mul, MD, H. E. M. de Boer, MD, W. Noordzij, MD, PhD, T. Korteweg, MD, PhD, H. M. van Dullemen, MD, PhD, W. B. Nagengast, MD, PhD, V. Oppedijk, MD, J. P. E. N. Pierie, MD, PhD, John Th. M. Plukker, MD, PhD

Published in: Annals of Surgical Oncology | Issue 7/2017

Abstract

Introduction

In patients with potentially resectable esophageal cancer (EC), the value of endoscopic ultrasonography (EUS) after fluorine-18 labeled fluorodeoxyglucose positron emission tomography with computed tomography (¹⁸F-FDG-PET/CT) is questionable. Retrospectively, we assessed the impact of EUS after PET/CT on the given treatment in EC patients.

Methods

During the period 2009–2015, 318 EC patients were staged as T1-4aN0-3M0 with hybrid ¹⁸F-FDG-PET/CT or ¹⁸F-FDG-PET with CT and EUS if applicable in a nonspecific order. We determined the impact of EUS on the given treatment in 279 patients who also were staged with EUS. EUS had clinical consequences if it changed curability, extent of radiation fields or lymph node resection (AJCC stations 2–5), and when the performed fine-needle aspiration (FNA) provided conclusive information of suspicious lymph node.

Results

EUS had an impact in 80 (28.7%) patients; it changed the radiation field in 63 (22.6%), curability in 5 (1.8%), lymphadenectomy in 48 (17.2%), and FNA was additional in 21 (7.5%). In patients treated with nCRT (n = 194), EUS influenced treatment in 53 (27.3%) patients; in 38 (19.6%) the radiation field changed, in 3 (1.5%) the curability, in 35 (18.0%) the lymphadenectomy, and in 17 (8.8%) FNA was additional. EUS influenced both the extent of radiation field and nodal resection in 31 (16.0%) nCRT patients.

Conclusions

EUS had an impact on the given treatment in approximately 29%. In most patients, the magnitude of EUS found expression in the extent of radiotherapy target volume delineation to upper/high mediastinal lymph nodes.

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Title: Impact of Endoscopic Ultrasonography on 18F-FDG-PET/CT Upfront Towards Patient Specific Esophageal Cancer Treatment
Authors: J. B. Hulshoff, MD
V. E. M. Mul, MD
H. E. M. de Boer, MD
W. Noordzij, MD, PhD
T. Korteweg, MD, PhD
H. M. van Dullemen, MD, PhD
W. B. Nagengast, MD, PhD
V. Oppedijk, MD
J. P. E. N. Pierie, MD, PhD
John Th. M. Plukker, MD, PhD
Publication date: 01-07-2017
Publisher: Springer International Publishing
Published in: Annals of Surgical Oncology / Issue 7/2017
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-017-5835-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Impact of Endoscopic Ultrasonography on ¹⁸F-FDG-PET/CT Upfront Towards Patient Specific Esophageal Cancer Treatment

Abstract

Introduction

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusions

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