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- Title
Change in volume parameters induced by neoadjuvant chemotherapy provide accurate prediction of overall survival after resection in patients with oesophageal cancer.
- Authors
Tamandl, Dietmar; Gore, Richard; Fueger, Barbara; Kinsperger, Patrick; Hejna, Michael; Paireder, Matthias; Haug, Alexander; Schoppmann, Sebastian; Ba-Ssalamah, Ahmed; Gore, Richard M; Schoppmann, Sebastian F
- Abstract
<bold>Objectives: </bold>To assess the prognostic value of volumetric parameters measured with CT and PET/CT in patients with neoadjuvant chemotherapy (NACT) and resection for oesophageal cancer (EC).<bold>Methods: </bold>Patients with locally advanced EC, who were treated with NACT and resection, were retrospectively analysed. Data from CT volumetry and (18) F-FDG PET/CT (maximum standardized uptake [SUVmax], metabolic tumour volume [MTV], and total lesion glycolysis [TLG]) were recorded before and after NACT. The impact of volumetric parameter changes induced by NACT (MTVRATIO, TLGRATIO, etc.) on overall survival (OS) was assessed using a Cox proportional hazards model.<bold>Results: </bold>Eighty-four patients were assessed using CT volumetry; of those, 50 also had PET/CT before and after NACT. Low post-treatment CT volume and thickness, MTV, TLG, and SUVmax were all associated with longer OS (p < 0.05), as were CTthicknessRATIO, MTVRATIO, TLGRATIO, and SUVmaxRATIO (p < 0.05). In the multivariate analysis, only MTVRATIO (Hazard ratio, HR 2.52 [95% Confidence interval, CI 1.33-4.78], p = 0.005), TLGRATIO (HR 3.89 [95%CI 1.46-10.34], p = 0.006), and surgical margin status (p < 0.05), were independent predictors of OS.<bold>Conclusions: </bold>MTVRATIO and TLGRATIO are independent prognostic factors for survival in patients after NACT and resection for EC.<bold>Key Points: </bold>• Change in PET parameters shows close correlation to survival in oesophageal cancer. • Association with OS is independent of changes in SUVmax and CT volume. • Metabolic parameters after NACT correlate with pathologic response and nodal status. • Metabolic parameters may be better suited than SUVmax for response assessment.
- Subjects
ESOPHAGEAL cancer; CANCER chemotherapy; CANCER-related mortality; DISEASE prevalence; CANCER patients
- Publication
European Radiology, 2016, Vol 26, Issue 2, p311
- ISSN
0938-7994
- Publication type
journal article
- DOI
10.1007/s00330-015-3860-7