Annals of Surgical Oncology

, Volume 17, Issue 1, pp 115–122 | Cite as

Prognostic Value of Metabolic Tumor Volume Measured by 18F-Fluorodeoxyglucose Positron Emission Tomography in Patients with Esophageal Carcinoma

  • Seung Hyup Hyun
  • Joon Young Choi
  • Young Mog Shim
  • Kwhanmien Kim
  • Su Jin Lee
  • Young Seok Cho
  • Ji Young Lee
  • Kyung-Han Lee
  • Byung-Tae Kim
Gastrointestinal Oncology



The aim of this study was to evaluate the prognostic value of metabolic tumor volume (MTV) measured by 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) in patients with esophageal carcinoma.


We retrospectively reviewed 151 patients with pathologically proven esophageal carcinoma (146 squamous cell carcinomas and 5 adenocarcinomas) who underwent pretreatment 18F-FDG PET. MTV and maximum standardized uptake value (SUVmax) for the primary tumors were measured by 18F-FDG PET. The prognostic significance of MTV, SUVmax, and other clinicopathological variables was assessed by Cox proportional hazards regression analysis. To further evaluate and compare the predictive performance of PET parameters, MTV and SUVmax, time-dependent receiver operating characteristic curve (ROC) analysis was used.


In the univariate analysis, age, American Joint Committee on Cancer (AJCC) stage, tumor–node–metastasis (TNM) factors, MTV, and SUVmax of primary tumor were significant predictors of survival. On multivariate analysis adjusted for age, sex, and treatment modality, independent predictive factors associated with decreased overall survival were T stage [hazard ratio (HR) 4.325, P = 0.006], M stage (HR 2.009, P = 0.007), and MTV (HR 1.013, P = 0.021). SUVmax was not a significant factor (HR 0.97, P = 0.061). On time-dependent ROC analysis, MTV showed good predictive performance for overall survival consistently better than SUVmax.


MTV, a volumetric parameter of 18F-FDG PET, is an important independent prognostic factor for survival and a better predictor of survival than SUVmax for the primary tumor in patients with esophageal carcinoma.


Positron Emission Tomography Standardize Uptake Value Esophageal Carcinoma Metabolic Tumor Volume Positron Emission Tomography Parameter 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



This study was supported by a grant from the Korea Health 21 R&D Project, Ministry of Health & Welfare, Republic of Korea (02-PJ3-PG6-EV06-0002).


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Copyright information

© Society of Surgical Oncology 2009

Authors and Affiliations

  • Seung Hyup Hyun
    • 1
  • Joon Young Choi
    • 1
  • Young Mog Shim
    • 2
  • Kwhanmien Kim
    • 2
  • Su Jin Lee
    • 1
  • Young Seok Cho
    • 1
  • Ji Young Lee
    • 1
  • Kyung-Han Lee
    • 1
  • Byung-Tae Kim
    • 1
  1. 1.Department of Nuclear Medicine, Samsung Medical CenterSungkyunkwan University School of MedicineSeoulRepublic of Korea
  2. 2.Department of Thoracic Surgery, Samsung Medical CenterSungkyunkwan University School of MedicineSeoulRepublic of Korea

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