Metabolic tumor volume provides complementary prognostic information to EUS staging in esophageal and junctional cancer

Summary To determine the correlation between 18F‐fluorodeoxyglucose positron emission tomography‐computed tomography (PET‐CT) derived esophageal tumor parameters [maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV)] and endoscopic ultrasound (EUS) derived tumor parameters (T stage, N stage) and their prognostic implications. 150 consecutive patients with cancer of the esophagus or esophagogastric junction underwent staging PET‐CT and staging EUS. PET‐CT derived SUVmax and MTV of the primary tumor was recorded. EUS evaluated T and N stage. Relationships between parameters were investigated using the Mann‐Whitney U tests, survival analysis performed using Kaplan‐Meier and independent prognostic factors determined using Cox regression multivariate analysis. A significant difference in MTV was noted between EUS T1/T2 tumors (median 6.7 cm3) and EUS T3/T4 tumors (median 35.7 cm3; P < 0.0001). An MTV of <23.4 cm3 (P = 0.0001), SUVmax < 4.1 (P = 0014), EUS T stage (P < 0.0001), EUS N stage (P < 0.0001), and clinical stage (P < 0.0001) were all significantly associated with survival, with MTV <23.4 cm3 (P = 0.004), EUS T stage (P = 0.01), and EUS N stage (P = 0.01) significant in multivariate analysis. MTV, a volumetric parameter of PET‐CT, has more prognostic importance than SUVmax and provides valuable prognostic information in esophageal and junctional cancer, along with EUS T and N s...
Source: Diseases of the Esophagus - Category: Gastroenterology Authors: Tags: Original Article Source Type: research