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Prognostic Value of Metabolic Tumor Volume Measured by 18F-Fluorodeoxyglucose Positron Emission Tomography in Patients with Esophageal Carcinoma

  • Gastrointestinal Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Purpose

The aim of this study was to evaluate the prognostic value of metabolic tumor volume (MTV) measured by 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) in patients with esophageal carcinoma.

Methods

We retrospectively reviewed 151 patients with pathologically proven esophageal carcinoma (146 squamous cell carcinomas and 5 adenocarcinomas) who underwent pretreatment 18F-FDG PET. MTV and maximum standardized uptake value (SUVmax) for the primary tumors were measured by 18F-FDG PET. The prognostic significance of MTV, SUVmax, and other clinicopathological variables was assessed by Cox proportional hazards regression analysis. To further evaluate and compare the predictive performance of PET parameters, MTV and SUVmax, time-dependent receiver operating characteristic curve (ROC) analysis was used.

Results

In the univariate analysis, age, American Joint Committee on Cancer (AJCC) stage, tumor–node–metastasis (TNM) factors, MTV, and SUVmax of primary tumor were significant predictors of survival. On multivariate analysis adjusted for age, sex, and treatment modality, independent predictive factors associated with decreased overall survival were T stage [hazard ratio (HR) 4.325, P = 0.006], M stage (HR 2.009, P = 0.007), and MTV (HR 1.013, P = 0.021). SUVmax was not a significant factor (HR 0.97, P = 0.061). On time-dependent ROC analysis, MTV showed good predictive performance for overall survival consistently better than SUVmax.

Conclusion

MTV, a volumetric parameter of 18F-FDG PET, is an important independent prognostic factor for survival and a better predictor of survival than SUVmax for the primary tumor in patients with esophageal carcinoma.

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Acknowledgment

This study was supported by a grant from the Korea Health 21 R&D Project, Ministry of Health & Welfare, Republic of Korea (02-PJ3-PG6-EV06-0002).

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Authors and Affiliations

  1. Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea

    Seung Hyup Hyun MD, Joon Young Choi MD, Su Jin Lee MD, Young Seok Cho MD, Ji Young Lee MD, Kyung-Han Lee MD & Byung-Tae Kim MD

  2. Department of Thoracic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea

    Young Mog Shim MD & Kwhanmien Kim MD

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  1. Seung Hyup Hyun MD
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Correspondence to Joon Young Choi MD.

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Hyun, S.H., Choi, J.Y., Shim, Y.M. et al. Prognostic Value of Metabolic Tumor Volume Measured by 18F-Fluorodeoxyglucose Positron Emission Tomography in Patients with Esophageal Carcinoma. Ann Surg Oncol 17, 115–122 (2010). https://doi.org/10.1245/s10434-009-0719-7

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