Accuracy of PET-CT in predicting survival in patients with esophageal cancer

Claire Brown, Ben Howes, Glyn G. Jamieson, Dylan Bartholomeusz, Urs Zingg, Thomas Sullivan, Sarah K. Thompson

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22 Citations (Scopus)

Abstract

Background: Positron emission tomography (PET) is an integral part of tumor staging for patients with esophageal cancer. Recent studies suggest a role for PET scan in predicting survival in these patients, but this relationship is unclear in the setting of neoadjuvant therapy. We examined pretreatment maximum standard uptake value (SUV max) of the primary tumor in patients treated with and without neoadjuvant therapy. Methods: All patients undergoing esophagectomy with a preoperative PET scan over a nine-year period (2001-2010) were identified from a prospectively maintained database. Positron emission tomography data were obtained from computers housing the original PET scans. Overall survival was correlated with SUV max of the primary tumor. Results: A total of 191 patients were identified, and 103 patients met inclusion criteria. Eighty-two had an adenocarcinoma (80%), and 21 (20%) had a squamous cell carcinoma. Fifty-seven (55%) patients received neoadjuvant therapy. In the surgery alone group, a SUV max of>5.0 in the primary tumor was associated with poor prognosis [Hazard Ratio (HR) 0.32; p = 0.007], but this factor did not retain its significance on multivariate analysis (HR 0.65; p = 0.43). Pretreatment SUV max in patients who underwent neoadjuvant therapy was not significant in predicting overall survival (p = 0.10). Conclusions: This study does not support the use of SUV max on pretreatment PET scans as a prognostic tool for patients with esophageal cancer, especially in those who have received neoadjuvant therapy. Lymph node status is a more accurate predictor of outcome, and efforts to improve pretreatment staging should focus on this factor.

LanguageEnglish
Pages1089-1095
Number of pages7
JournalWorld Journal of Surgery
Volume36
Issue number5
DOIs
Publication statusPublished - 1 May 2012
Externally publishedYes

ASJC Scopus subject areas

  • Surgery

Cite this

Brown, C., Howes, B., Jamieson, G. G., Bartholomeusz, D., Zingg, U., Sullivan, T., & Thompson, S. K. (2012). Accuracy of PET-CT in predicting survival in patients with esophageal cancer. World Journal of Surgery, 36(5), 1089-1095. https://doi.org/10.1007/s00268-012-1470-y