Retrospective Study
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World J Gastrointest Oncol. May 15, 2014; 6(5): 139-144
Published online May 15, 2014. doi: 10.4251/wjgo.v6.i5.139
Prognostic value of baseline FDG uptake on PET-CT in esophageal carcinoma
Omar S Al-Taan, Amar Eltweri, David Sharpe, Peter M Rodgers, Sukhbir S Ubhi, David J Bowrey
Omar S Al-Taan, Amar Eltweri, David Sharpe, Sukhbir S Ubhi, David J Bowrey, Departments of Surgery, University Hospitals of Leicester, Leicester LE1 5WW, United Kingdom
Peter M Rodgers, Departments of Radiology, University Hospitals of Leicester, Leicester LE1 5WW, United Kingdom
Author contributions: Ubhi SS and Bowrey DJ designed the research; Eltweri A and Sharpe D performed the research; Sharpe D and Bowrey DJ analyzed data; Al-Taan OS, Rodgers PM, Ubhi SS and Bowrey DJ wrote the paper.
Correspondence to: Dr. David J Bowrey, Consultant Surgeon and Honorary Senior Lecturer, Department of Surgery, University Hospitals of Leicester, Level 6 Balmoral Building, Leicester Royal Infirmary, Leicester LE1 5WW, United Kingdom. djb57@le.ac.uk
Telephone: +44-116-2585247 Fax: +44-116-2586083
Received: November 12, 2013
Revised: February 19, 2014
Accepted: April 11, 2014
Published online: May 15, 2014
Processing time: 183 Days and 9.6 Hours
Abstract

AIM: To evaluate the influence of baseline maximum standardized uptake value (SUVmax) on survival in a cohort of patients, undergoing positron emission tomography-computed tomography (PET-CT) scan for esophageal carcinoma.

METHODS: The pre-treatment SUVmax numeric reading was determined in patients with confirmed esophageal or junctional cancer having PET-CT scan during the time period 1st January 2007 until 31st July 2012. A minimum follow up of 12 mo was required. Patients were subdivided into quartiles according to SUVmax value and the influence of SUVmax on survival was assessed using univariate and multivariate analysis. The following pre-treatment factors were investigated: patient characteristics, tumor characteristics and planned treatment.

RESULTS: The study population was 271 patients (191 male) with esophageal or junctional carcinoma. The median age was 65 years (range 40-85) and histologic subtype was adenocarcinoma in 197 patients and squamous carcinoma in 74 patients. The treatment intent was radical in 182 and palliative in 89 patients. SUVmax was linked to histologic subtype (P = 0.008), tumor site (P = 0.01) and Union for International Cancer Control (UICC) stage (P < 0.001). On univariate analysis, prognosis was significantly associated with SUVmax (P = 0.001), T-stage (P < 0.001) and UICC stage (P < 0.001). On multivariate analysis, only T-stage and UICC stage remained significant.

CONCLUSION: Pretreatment SUVmax was not a useful marker in isolation for determining prognosis of patients with esophageal carcinoma.

Keywords: Esophageal neoplasms; Fluorodeoxyglucose F18; Positron emission tomography; Positron emission tomography-computed tomography; Prognosis

Core tip: Positron emission tomography-computed tomography (PET-CT) is integral to the staging of esophageal cancer. It is unclear whether the value of PET-CT extends beyond the identification of metastatic disease. The influence of PET-CT maximum standardized uptake value (SUVmax) on prognosis was determined for 271 patients. Although SUVmax was closely linked to disease stage, it did not exert an independent effect and was not a useful prognostic marker.