Metabolic Tumor Volume Change Predicts Long-term Survival and Histological Response to Preoperative Chemotherapy in Locally Advanced Esophageal Cancer

Objective: Here, we assess the ability of metabolic tumor volume (MTV) as measured by 18F-fluorodeoxyglucose-positron emission tomography/computed tomography (18F-FDG PET/CT) to evaluate neoadjuvant chemotherapy response for patients with locally advanced esophageal cancer (EC). Background: Optimal methods to evaluate treatment response for EC patients have not yet been established. Although previous studies have reported the value of standardized uptake value (SUV), the accuracy of predicting histological response or long-term survival in EC is limited. Methods: In all, 102 EC patients without distant metastasis who underwent 18F-FDG PET/CT both before and after the preoperative chemotherapy series were analyzed. Results: The median primary tumor MTV values before and after preoperative chemotherapy were 22.55 (range 0.4–183.1) and 2.75 (0–52.9), respectively, and the median MVT reduction rate was 86.5%. We found the most significant difference in survival between PET responders and nonresponders with a cut-off value of 60% MTV reduction, using a 10% stepwise cut-off analysis [2-year progression-free survival (PFS): 79.2 vs 44.4%; hazard ratio (HR) 3.397; P
Source: Annals of Surgery - Category: Surgery Tags: ORIGINAL ARTICLES Source Type: research