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The Quarterly Journal of Nuclear Medicine and Molecular Imaging 2020 June;64(2):211-8

DOI: 10.23736/S1824-4785.18.03041-8

Copyright © 2018 EDIZIONI MINERVA MEDICA

lingua: Inglese

Total FDG lesion number on PET/CT predicts survival of esophageal carcinoma patients with recurrence following curative surgery

Soo J. KIM 1, Seung H. HYUN 1, Seung H. MOON 1, Young S. CHO 1, Hyun K. YI 1, Young M. SHIM 2, Joon Y. CHOI 1, Byung-Tae KIM 1, Kyung-Han LEE 1

1 Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea; 2 Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea



BACKGROUND: Total lesion number is a prognostic determinant in recurrent esophageal cancer, but this requires multiple tests. Here, we investigated the prognostic value of total FDG lesion number obtained from a single PET/CT study.
METHODS: Subjects were 153 esophageal squamous cell carcinoma patients with loco-regional or distant recurrence following curative surgery. FDG PET/CT performed within 30 days was inspected for abnormal FDG uptake lesions using a SUVmax of 3.0 as threshold for significance. Prognostic associations were assessed by Cox proportional hazards regression and Kaplan-Meier analysis.
RESULTS: PET/CT showed significant local FDG lesions in 49.0%, regional lesions in 78.4%, and distant lesions in 44.4% of patients. Among 73 patients with loco-regional recurrence, 54 had 0-3 and 19 had ≥4 FDG lesions. Among 80 patients with distant recurrence, 31 had 0-3 and 49 had ≥4 FDG lesions. During a median follow-up of 11.8 months, 99 deaths occurred. Univariate variables associated with poor survival included ≥4 FDG lesions and no treatment for loco-regional recurrence and no treatment for distant recurrence. Kaplan Meier analysis showed worse survival for ≥4 than 0-3 FDG lesions in patients with loco-regional recurrence (15.6 vs. 32.1 months; P=0.009), but not in those with distant recurrence. Significant independent predictors of poor survival were ≥4 FDG lesions and no treatment for loco-regional recurrence and no treatment for distant recurrence.
CONCLUSIONS: Total FDG lesion number assessed by PET/CT is a significant independent prognostic factor in esophageal cancer patients with loco-regional recurrence following curative surgery.


KEY WORDS: Fluorodeoxyglucose F18; Positron emission tomography/computed tomography; Neoplasm recurrence, local; Survival; Esophageal squamous cell carcinoma

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