Skip to main content

Advertisement

Log in

18F-FDG PET/CT as a potential predictor of survival in patient with oesophageal cancer: a preliminary result

  • Published:
Abdominal Imaging Aims and scope Submit manuscript

Abstract

Aims

A study was undertaken to investigate the value of pretreatment PET–CT in predicting survival in patients with oesophageal cancer (OC).

Methods

Between June 2010 and December 2011, 18 consecutive OC patients median (61.00 ± 12.07 years) with median survival of 7.5 month had a pretreatment PET–CT scan. Staging of the disease was made in accordance to the American Joint Committee on Cancer staging system (7th edition) and grouped as stage I–IIA and stage IIB–IV. Maximum standardized uptake value (SUVmax), size of a primary tumour and the presence of fluorodeoxyglucose (FDG)-avid lymph nodes were evaluated for all patients. Survival was analysed using the Kaplan–Meier product limit method and Cox proportional hazards regression model.

Results

PET–CT stages I–IIA and IIB–IV had a 1-year survival of 50% and 25%, respectively. Patient with size of primary tumour (<4.5 cm) had significantly (p < 0.036) better survival than those with large size (>4.5 cm). Multivariate Cox regression analysis showed that SUVmax of >5.5 in the primary tumour [hazard ratio (HR) 23.017; 95% confidence interval, p = 0.038] and the presence of FDG-avid lymph node (HR 1.248; p = 0.028) were strongly predictive of poor overall survival on multivariate analysis.

Conclusion

Pretreatment 18F-FDG PET–CT SUVmax of a primary tumour and the presence of FDG-avid lymph nodes independently predict survival in patients with oesophageal carcinoma which may potentially be used as surrogate markers for prognostic and therapeutic purposes.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. Surveillance Epidemiology and End Results (SEER). Available at: http://seer.cancer.gov/statistics/. Accessed April 16, 2012

  2. Skehan SJ, Brown AL, Thompson M, et al. (2000) Imaging features of primary and recurrent esophageal cancer at FDG PET. Radiographics 20(3):713

    Article  CAS  PubMed  Google Scholar 

  3. American Cancer Society (2003) Cancer facts and figures 2003. Atlanta: American Cancer Society

    Google Scholar 

  4. Westerterp M, Sloof GW, Hoekstra OS, et al. (2008) 18FDG uptake in esophageal adenocarcinoma: linking biology and outcome. J Cancer Res Clin Oncol 134:227–236

    Article  PubMed  Google Scholar 

  5. Choi JY, Lee KH, Shim YM, et al. (2000) Improved detection of individual nodal involvement in squamous cell carcinoma of the esophagus by FDG PET. J Nucl Med 41:808–815

    CAS  PubMed  Google Scholar 

  6. Lina C-Y, Dingb H-J, Chenc Y-K, et al. (2008) F-18 FDG PET in detecting uterine leiomyoma. Clin Imaging 32(1):38–41

    Article  Google Scholar 

  7. van Vliet EP, Heijenbrok-Kal MH, Hunink MG, Kuipers EJ, Siersema PD (2008) Stag-ing investigations for oesophageal cancer: a meta-analysis. Br J Cancer 98:547–557

    Article  PubMed Central  PubMed  Google Scholar 

  8. Fathinul Fikri AS, Kroiss A, Ahmad ZF, et al. (2014) Localization and prediction of malignant potential in recurrent pheochromocytoma/paraganglioma (PCC/PGL) using 18F-FDG PET/CT. Acta Radiol 55(5):631–640. doi:10.1177/0284185113504330

    Article  Google Scholar 

  9. Fukunaga T, Okazumi S, Koide Y, Isono K, Imazeki K (1998) Evaluation of esophageal cancers using fluorine-18-fluorodeoxyglucose PET. J Nucl Med 39:1002–1007

    CAS  PubMed  Google Scholar 

  10. Rizk NP, Tang L, Adusumilli PS, et al. (2009) Predictive value of initial PET-SUVmax in patients with locally advanced esophageal and gastroesophageal junction adenocarcinoma. J Thorac Oncol. 4(7):875–879

    Article  PubMed  Google Scholar 

  11. Fathinul F, Nordin AJ, Lau WFE (2013) 18[F] FDG-PET/CT is a useful molecular marker in evaluating tumour aggressiveness; a revised understanding of an in-vivo FDGPET imaging that alludes the alteration of cancer biology. Cell Biochem Biophys 66:37–43. doi:10.1007/s12013-012-9395-5

    Article  CAS  PubMed  Google Scholar 

  12. Fathinul Fikri AS, Nordin AJ, Mokhtarudin N, Hemalata A, Lau WFE (2011) 18[F] FDG-PET/CT is a useful molecular marker in evaluating thymoma aggressiveness. Eur J Radiol Extra. 78(2):89–92

    Article  Google Scholar 

  13. Rice TW, Blackstone EH, Rusch VW (2010) 7th Edition of the AJCC Cancer Staging Manual: esophagus and esophagogastric junction. Ann Surg Oncol 17(7):1721–1724

    Article  PubMed  Google Scholar 

  14. Kato H, Kimura H, Nakajima M, et al. (2008) The additional value of integrated PET/CT over PET in initial lymph node staging of esophageal cancer. Oncol Rep 20:857–862

    PubMed  Google Scholar 

  15. Roedl JB, Prabhakar HB, Mueller PR, Colen RR, Blake MA (2009) Prediction of metastatic disease and survival in patients with gastric and gastroesophageal junction tumors: the incremental value of PET-CT over PET and the clinical role of primary tumor volume measurements. Acad Radiol 16:218–226

    Article  PubMed  Google Scholar 

  16. Yasuda T, Higuchi I, Yano M, et al. (2012) The impact of 18F-fluorodeoxyglucose positron emission tomography positive lymph nodes on postoperative recurrence and survival in resectable thoracic esophageal squamous cell carcinoma. Ann Surg Oncol 19:652–660

    Article  PubMed  Google Scholar 

  17. Gillies RS, Middleton MR, Han C, et al. (2012) Role of positron emission tomography-computed tomography in predicting survival after neoadjuvant chemotherapy and surgery for oesophageal adenocarcinoma. Br J Surg 99(2):239–245

    Article  CAS  PubMed  Google Scholar 

  18. Williams RN, Ubhi SS, Sutton CD, et al. (2009) The early use of PET-CT alters the management of patient with esophageal cancer. J Gastrointes Surg 13:868–873

    Article  CAS  Google Scholar 

  19. Boris S, Daniel PR, Marek P, et al. (2009) Does the value of PET-CT extend beyond pretreatment staging? An analysis of survival in surgical patients with esophageal cancers. J Gastrointest Surg. doi:10.1007/s11605-009-1038-9

    Google Scholar 

  20. Facey K, Bradbury I, Laking G, et al. (2007) Overview of the clinical effectiveness of positron emission tomography imaging in selected cancers. Health Technol Assess 11:iii-iv, xi-267

    Article  PubMed  Google Scholar 

  21. Vliet EPM, Heijenbrok-Kal MH, Hunink MGM, et al. (2008) Staging investigation for esophageal cancer: a meta-analysis. Br J Cancer 98:547–557

    Article  PubMed Central  PubMed  Google Scholar 

  22. Vaupel P, Mayer A (2007) Hypoxia in cancer: significance and impact on clinical outcome. Cancer Metastasis Rev 26:225–239

    Article  CAS  PubMed  Google Scholar 

  23. Wang BY, Goan YG, Hsu PK, Hsu WH, Wu YC (2011) Tumor length as a prognostic factor in esophageal squamous cell carcinoma. Ann Thorac Surg 91(3):887–893. doi:10.1016/j.athoracsur.2010.11.011

    Article  PubMed  Google Scholar 

  24. Wu N, Pang LW, Chen ZM, Ma QY, Chen G (2012) Tumour length is an independent prognostic factor of esophageal squamous cell carcinomas. Chin Med J. 125(24):4445–4448

    CAS  PubMed  Google Scholar 

  25. Wang BY, Liu CY, Lin CH, et al. (2012) Endoscopic tumor length is an independent prognostic factor in esophageal squamous cell carcinoma. Ann Surg Oncol 19(7):2149–2158

    Article  PubMed  Google Scholar 

  26. Hyun SH, Choi JY, Shim YM, et al. (2010) Prognostic value of metabolic tumor volume measured by 18F-fluorodeoxyglucose positron emission tomography in patients with esophageal carcinoma. Ann Surg Oncol 17(1):115–122

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

We are grateful to Dr R. Dharmendran and his colleagues of the Hospital Tuanku Ja’afar Seremban for their joint effort in the data collection process for all patients in this study.

Conflict of interest

None.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to A. S. Fathinul Fikri.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Fathinul Fikri, A.S., Dharmendran, R., Vikneswaran, P. et al. 18F-FDG PET/CT as a potential predictor of survival in patient with oesophageal cancer: a preliminary result. Abdom Imaging 40, 1457–1464 (2015). https://doi.org/10.1007/s00261-014-0343-2

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00261-014-0343-2

Keywords

Navigation