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Does the Value of PET-CT Extend Beyond Pretreatment Staging? An Analysis of Survival in Surgical Patients with Esophageal Cancer

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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background

Studies of positron emission tomography (PET) have focused mainly on tumor staging. The role of PET in predicting survival has received less attention. We sought to assess the relationship of pretreatment maximum standard uptake value (SUVmax) to survival in surgical patients with esophageal cancer.

Methods

The study consisted of 72 esophagectomy patients (60 with adenocarcinoma) undergoing resection between July 2005 and April 2009. PET combined with computed tomography (PET-CT) was performed at a single center, and SUVmax was recorded prior to any therapy. Survival was assessed at a median follow-up of 19 months.

Results

The median SUVmax was 6.25. A receiver operating characteristic curve identified SUVmax 4.5 to optimally discriminate survival. Patients with low SUVmax (<4.5) had significantly (p = 0.0003) better survival than those with high SUVmax (≥4.5). Stage 3 patients with low SUVmax had significantly better survival (p = 0.0069) than those with high SUVmax. Likewise, N1 disease patients with low SUVmax had significantly better survival (p = 0.008) than those with high SUVmax. Multivariate analysis identified SUVmax to be an independent predictor of survival (p = 0.0021).

Conclusion

Pretreatment PET-CT SUVmax independently predicts survival in patients with esophageal carcinoma undergoing resection. SUVmax may be a valuable marker of tumor biology that could potentially be exploited for prognostic and therapeutic purposes.

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Authors and Affiliations

  1. Division of Thoracic and Foregut Surgery, University of Rochester Medical Center, Rochester, NY, USA

    Boris Sepesi, Daniel P. Raymond, Marek Polomsky, Thomas J. Watson, Virginia R. Litle, Carolyn E. Jones & Jeffrey H. Peters

  2. Department of Biostatistics and Computational Biology, University of Rochester, Rochester, NY, USA

    Rui Hu & Xing Qiu

  3. Department of Surgery, University of Rochester School of Medicine & Dentistry, 601 Elmwood Ave, BOX SURG, Rochester, NY, 14642, USA

    Jeffrey H. Peters

Authors
  1. Boris Sepesi
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  2. Daniel P. Raymond
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  3. Marek Polomsky
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  4. Thomas J. Watson
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  5. Virginia R. Litle
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  6. Carolyn E. Jones
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  7. Rui Hu
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  8. Xing Qiu
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  9. Jeffrey H. Peters
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Corresponding author

Correspondence to Jeffrey H. Peters.

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Sepesi, B., Raymond, D.P., Polomsky, M. et al. Does the Value of PET-CT Extend Beyond Pretreatment Staging? An Analysis of Survival in Surgical Patients with Esophageal Cancer. J Gastrointest Surg 13, 2121–2127 (2009). https://doi.org/10.1007/s11605-009-1038-9

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  • DOI: https://doi.org/10.1007/s11605-009-1038-9

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