Chemoradiotherapy for locally advanced cervix cancer without aortic lymph node involvement: can we consider metabolic parameters of pretherapeutic FDG-PET/CT for treatment tailoring?

Abstract Objectives This prospective study assessed the role of F-18-FDG-PET/CT in clinical staging for patients with colorectal cancer planned for pulmonary metastasectomy by thoracotomy or video-assisted surgery. Patients and methods In addition to conventional imaging, we performed 86 F-18-FDG-PET/CT studies in 76 patients with potentially resectable metastatic colorectal lung metastases. We then investigated the effect that PET/CT had on further clinical management. Based on the results from the 47 thoracotomies performed, we compared the number of pulmonary metastases discovered after histologic examination with the number predicted by the conventional computed tomography (CT) as an independent part of the F-18-FDG-PET/CT examination and by the F-18-FDG-PET component. Results F-18-FDG-PET/CT led to changes in treatment regime and diagnostic planning in many patients. In five patients PET/CT revealed previously undetected local recurrence of the primary colorectal cancer, in four patients hepatic metastases, in three patients bone metastases, in two patients soft-tissue metastases, and in three patients histologically preoperatively proven N2 or N3 station lymph node involvement. These all constituted exclusion criteria, and consequently the previously planned pulmonary metastasectomy was not performed. The sensitivity and positive predictive value (PPV) for detection of pulmonary metastases were 84.2% and 36.4% for CT and 75.0% and 61.6% for F-18-FDG-PET study. The calculated sensitivity, specificity, PPV, and NPV of F-18-FDG-PET/CT for detecting thoracic lymph node involvement were 85.7%, 93.0%, 66.7%, and 97.5%, respectively. Furthermore, we found that F-18-FDG-PET/CT may predict thoracic lymph node involvement based on the SUV of pulmonary nodules. Conclusions F-18-FDG-PET/CT has a clear role in the diagnostic workup for pulmonary metastatic colorectal cancer and may save patients from futile surgery. It cannot, however, be relied on to detect all possible pulmonary and nodal metastases, which surgeons must always consider when making treatment decisions.

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OC-0130 18F-FDG PET/CT FOR THE ASSESSMENT OF LOCOREGIONAL LYMPH NODE INVOLVEMENT IN STAGE II AND III BREAST CANCER

Radiotherapy and Oncology ◽

10.1016/s0167-8140(12)70469-3 ◽

2012 ◽

Vol 103 ◽

pp. S51

Author(s):

B.B. Koolen ◽

R.A. Valdés Olmos ◽

P.H. Elkhuizen ◽

W.V. Vogel ◽

M. Vrancken Peeters ◽

...

Keyword(s):

Breast Cancer ◽

Lymph Node ◽

Fdg Pet ◽

Lymph Node Involvement ◽

Stage Ii ◽

Pet Ct ◽

Node Involvement ◽

18F Fdg ◽

Fdg Pet Ct ◽

Locoregional Lymph Node

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PS02.089: METABOLIC RESPONSE FOR CHEMORADIOTHERAPY PREDICTS PROGNOSIS OF PATIENTS TREATED WITH NEOADJUVANT THERAPY PLUS ESOPHAGECTOMY FOR ADVANCED ESOPHAGEAL CANCER

Diseases of the Esophagus ◽

10.1093/dote/doy089.ps02.089 ◽

2018 ◽

Vol 31 (Supplement_1) ◽

pp. 145-146

Author(s):

Satoru Motoyama ◽

Yusuke Sato ◽

Akiyuki Wakita ◽

Yuta Kawakita ◽

Yushi Nagaki ◽

...

Keyword(s):

Multivariate Analysis ◽

Prognostic Factors ◽

Lymph Node ◽

Fdg Pet ◽

Metabolic Response ◽

Lymph Node Involvement ◽

Survival Outcome ◽

Pet Ct ◽

Node Involvement ◽

Fdg Pet Ct

Abstract Background We evaluated that metabolic response using [18F]-Fluorodeoxyglucose positron-emission tomography/computed tomography (PET/CT) predicts survival outcome in patients treated with neoadjuvant chemoradiotherapy (NACRT) plus esophagectomy for thoracic esophageal squamous cell carcinoma (TESCC). Methods Fifty consecutive Japanese patients with cStage IIB-IV TESCC, treated at our hospital between April 2009 and January 2014, were enrolled. We analyzed the metabolic response (fractional decrease in tumor maximum standardized uptake value) to NACRT. Independent prognostic factors predictive of 3-year survival were investigated using univariate and multivariate analysis. Results The study participants included 41 (82%) males and 9 (18%) females, with an age of 62.5 (rage 43–74) years. All 42 patients examined were found to be positive for tumors on FDG-PET/CT before treatment. After NACRT, 28% (10/36) of patients had changed from positive to negative for tumor on FDG-PET/CT. Seventy-one percent (30/42) of patients were positive for lymph node involvement on FDG-PET/CT before treatment. After NACRT, 81% (22/27) of patients previously positive for lymph node involvement were negative on FDG-PET/CT. The median fractional decrease in tumor SUVmax was 75% (range = 19–90%). We found that there was a significant correlation between a decrease in FDG-PET/CT and recurrence. Consistent with those findings, univariate and multivariate analysis taking into consideration age, gender, cT, cN, cM, adverse events, interval between NACRT and surgery, number of dissected LNs, pT, pN, pCR, pathological response, and fractional decrease in tumor SUVmax showed that fractional decrease in tumor SUVmax of < 75% to be significant prognostic factors associated with poorer survival. Conclusion Metabolic response as a decrease in SUVmax of ≥ 75% was an independent prognostic factor for 3-year overall survival in multivariate analysis and associated with recurrence. On the other hand, cT, cN, pT, pN, pCR were not associated with survival outcome or recurrence. Disclosure All authors have declared no conflicts of interest.

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