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Prognostic Impact of Clinicopathological Features and Expression of Biomarkers Related to 18F-FDG Uptake in Esophageal Cancer

  • Thoracic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Purpose

To analyze the association between pretreatment 18-F-fluoro-deoxyglucose (FDG) uptake and characteristics of aggressive tumor biology in predicting outcome in esophageal cancer (EC).

Methods

Tumor FDG-uptake was measured by maximum standardized uptake values (SUVmax) in 47 patients undergoing esophagectomy with curative intent. ROC analyses were used to predict an optimal SUVmax cutoff for survival. Expression of hexokinase-II (HK-II), glucose transporter I (GLUT-I), hypoxia inducible factor-1α (HIF-Iα), vascular endothelial growth factor-C (VEGF-C), p53, and proliferative activity (Ki-67) were correlated with SUVmax values and clinicopathological characteristics.

Results

A SUVmax > 3.67 predicted a significantly lower disease-free survival (DFS) and distant recurrence-free survival (p = 0.022 and p = 0.005). High HK-II expression was correlated with reduced SUVmax values (p = 0.002) and was significantly higher in esophageal adenocarcinoma compared with squamous cell carcinoma (p = 0.005). Preoperative high FDG uptake in primary tumors was associated with nodal metastases (pN1; Spearman correlation 0.39, p = 0.01). We found no positive correlation between SUVmax and GLUT-1, HK-1, HIF-Iα 1, VEGF-C, p53, and Ki-67 expression.

Conclusions

High preoperative FDG-uptake strongly predicts poor survival outcome and is associated with lymph node metastases in EC patients. HK-II expression was related to SUVmax and DFS.

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Disclosure

No commercial, financial or personal conflicts of interest.

Author information

Authors and Affiliations

  1. Department of Surgical Oncology/Gastrointestinal Surgery, University of Groningen/University Medical Center Groningen, Hanzeplein 1, 9700 RB, Groningen, The Netherlands

    L. M. A. Schreurs MD, PhD, J. K. Smit MD, PhD, B. B. Pultrum MD, PhD & John Th. M. Plukker MD

  2. Department of Gastroenterology and Hepatology, University of Groningen/University Medical Center Groningen, Groningen, The Netherlands

    K. Pavlov MD

  3. Department of Surgery, Medical Spectrum Twente, Enschede, The Netherlands

    L. M. A. Schreurs MD, PhD

  4. Department of Nuclear Medicine and Molecular Biology, University of Groningen/University Medical Center Groningen, Groningen, The Netherlands

    J. Pruim MD, PhD

  5. Department of Epidemiology, University of Groningen/University Medical Center Groningen, Groningen, The Netherlands

    H. Groen MD, PhD

  6. Department of Pathology, University of Groningen/University Medical Center Groningen, Groningen, The Netherlands

    H. Hollema MD, PhD

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  1. L. M. A. Schreurs MD, PhD
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  8. John Th. M. Plukker MD
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Correspondence to John Th. M. Plukker MD.

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Schreurs, L.M.A., Smit, J.K., Pavlov, K. et al. Prognostic Impact of Clinicopathological Features and Expression of Biomarkers Related to 18F-FDG Uptake in Esophageal Cancer. Ann Surg Oncol 21, 3751–3757 (2014). https://doi.org/10.1245/s10434-014-3848-6

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  • DOI: https://doi.org/10.1245/s10434-014-3848-6

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