Value of baseline positron emission tomography for predicting overall survival in patient with nonmetastatic esophageal or gastroesophageal junction carcinoma

David Hong, Simon Lunagomez, E. Edmund Kim, Jeffery H. Lee, Robert S. Bresalier, Stephen G. Swisher, Tsung Tse Wu, Jeffery Morris, Zhongxing Liao, Ritsuko Komaki, Jaffer A. Ajani

Research output: Contribution to journalArticle

57 Scopus citations

Abstract

BACKGROUND. The value of baseline positron emission tomography (PET) for predicting overall survival (OS) or disease-free survival (DFS) is unclear in patients with nondistant metastatic (locoregional only) esophageal carcinoma. The authors tested the hypothesis that, in this setting, the number of PET abnormalities (NPA) would correlate with OS and DFS. METHODS. The authors of the current study analyzed patients with localized esophageal carcinoma (Stages II and III) who had a baseline PET and endoscopic ultrasonography (EUS) and were all treated with chemoradiotherapy followed by surgery. The standardized uptake value (SUV) of PET avid lesions were evaluated for: SUV of the primary, NPA, peak SUV, and total SUV. Correlations were performed with baseline EUS results, OS, DFS, and clinical and pathologic response. RESULTS. Forty-seven patients who underwent chemoradiotherapy followed by surgery were analyzed. Most patients had clinical Stage III cancer. NPA was significantly associated with OS (Cox model, P = 0.02; log-rank test, P = 0.04) and DFS (P = 0.04). Patients with NPA > 1 had a death hazard ratio of 4.49 (reference, NPA = 1). In a multivariate analysis, NPA was independently predictive of OS (P = 0.03). Alternatively, SUV of the primary tumor, peak SUV, total SUV, and EUS clinical stage did not correlate with the type of response, OS or DFS. CONCLUSIONS. Data from the current study suggest that for nondistant metastatic esophageal carcinoma, baseline PET can predict patient outcome. Baseline NPA (> 1), reflecting the regional nodal metastases, is an independent predictor of OS. Baseline PET may become a useful stratification factor in randomized trials and for individualizing therapy.

Original languageEnglish (US)
Pages (from-to)1620-1626
Number of pages7
JournalCancer
Volume104
Issue number8
DOIs
StatePublished - Oct 15 2005

Keywords

  • Baseline positron emission tomography
  • Disease-free survival
  • Esophageal carcinoma
  • Non-distant metastases
  • Overall survival

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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    Hong, D., Lunagomez, S., Edmund Kim, E., Lee, J. H., Bresalier, R. S., Swisher, S. G., Wu, T. T., Morris, J., Liao, Z., Komaki, R., & Ajani, J. A. (2005). Value of baseline positron emission tomography for predicting overall survival in patient with nonmetastatic esophageal or gastroesophageal junction carcinoma. Cancer, 104(8), 1620-1626. https://doi.org/10.1002/cncr.21356