Change in volume parameters induced by neoadjuvant chemotherapy provide accurate prediction of overall survival after resection in patients with oesophageal …
D Tamandl, RM Gore, B Fueger, P Kinsperger… - European …, 2016 - Springer
D Tamandl, RM Gore, B Fueger, P Kinsperger, M Hejna, M Paireder, A Haug…
European radiology, 2016•SpringerObjectives 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). Methods 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 …
PET/CT in patients with neoadjuvant chemotherapy (NACT) and resection for oesophageal
cancer (EC). Methods 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 …
Objectives
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).
Methods
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.
Results
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.
Conclusions
MTVRATIO and TLGRATIO are independent prognostic factors for survival in patients after NACT and resection for EC.
Key points
• 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.
Springer
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