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01-02-2016 | Oncology

Change in volume parameters induced by neoadjuvant chemotherapy provide accurate prediction of overall survival after resection in patients with oesophageal cancer

Authors: Dietmar Tamandl, Richard M. Gore, Barbara Fueger, Patrick Kinsperger, Michael Hejna, Matthias Paireder, Alexander Haug, Sebastian F. Schoppmann, Ahmed Ba-Ssalamah

Published in: European Radiology | Issue 2/2016

Abstract

Objectives

To assess the prognostic value of volumetric parameters measured with CT and PET/CT in patients with neoadjuvant chemotherapy (NACT) and resection for oesophageal cancer (EC).

Methods

Patients with locally advanced EC, who were treated with NACT and resection, were retrospectively analysed. Data from CT volumetry and ¹⁸ F-FDG PET/CT (maximum standardized uptake [SUVmax], metabolic tumour volume [MTV], and total lesion glycolysis [TLG]) were recorded before and after NACT. The impact of volumetric parameter changes induced by NACT (MTV_RATIO, TLG_RATIO, etc.) on overall survival (OS) was assessed using a Cox proportional hazards model.

Results

Eighty-four patients were assessed using CT volumetry; of those, 50 also had PET/CT before and after NACT. Low post-treatment CT volume and thickness, MTV, TLG, and SUVmax were all associated with longer OS (p < 0.05), as were CTthickness_RATIO, MTV_RATIO, TLG_RATIO, and SUVmax_RATIO (p < 0.05). In the multivariate analysis, only MTV_RATIO (Hazard ratio, HR 2.52 [95 % Confidence interval, CI 1.33–4.78], p = 0.005), TLG_RATIO (HR 3.89 [95%CI 1.46–10.34], p = 0.006), and surgical margin status (p < 0.05), were independent predictors of OS.

Conclusions

MTV_RATIO and TLG_RATIO are independent prognostic factors for survival in patients after NACT and resection for EC.

Key points

• Change in PET parameters shows close correlation to survival in oesophageal cancer.

• Association with OS is independent of changes in SUVmax and CT volume.

• Metabolic parameters after NACT correlate with pathologic response and nodal status.

• Metabolic parameters may be better suited than SUVmax for response assessment.

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Title: Change in volume parameters induced by neoadjuvant chemotherapy provide accurate prediction of overall survival after resection in patients with oesophageal cancer
Authors: Dietmar Tamandl
Richard M. Gore
Barbara Fueger
Patrick Kinsperger
Michael Hejna
Matthias Paireder
Alexander Haug
Sebastian F. Schoppmann
Ahmed Ba-Ssalamah
Publication date: 01-02-2016
Publisher: Springer Berlin Heidelberg
Published in: European Radiology / Issue 2/2016
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-015-3860-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Change in volume parameters induced by neoadjuvant chemotherapy provide accurate prediction of overall survival after resection in patients with oesophageal cancer

Abstract

Objectives

Methods

Results

Conclusions

Key points

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

Key points

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