Metabolic Tumor Volume Change Predicts Long-term Survival and Histological Response to Preoperative Chemotherapy in Locally Advanced Esophageal Cancer

2019 ◽  
Vol 270 (6) ◽  
pp. 1090-1095 ◽  
Author(s):  
Tomoki Makino ◽  
Makoto Yamasaki ◽  
Koji Tanaka ◽  
Yasunori Masuike ◽  
Mitsuaki Tatsumi ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Volume Change ◽  
Tumor Volume ◽  
Locally Advanced ◽  
Metabolic Tumor Volume ◽  
Histological Response ◽  
Advanced Esophageal Cancer ◽  
Term Survival ◽  
Locally Advanced Esophageal Cancer

Prognostic value of 18F-FDG PET/CT metabolic tumor volume for complete pathologic response and clinical outcomes after neoadjuvant chemoradiation therapy for locally advanced esophageal cancer.

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 150-150
Author(s):  
Puja Venkat ◽  
Jasmine A Oliver ◽  
Will Jin ◽  
Joshua Dault ◽  
Jessica M. Frakes ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Prognostic Value ◽  
Tumor Volume ◽  
Locally Advanced ◽  
Standardized Uptake Value ◽  
Metabolic Tumor Volume ◽  
Neoadjuvant Chemoradiation ◽  
Advanced Esophageal Cancer ◽  
Pet Ct ◽  
Locally Advanced Esophageal Cancer

150 Background: The prognostic value of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) has not yet been defined in locally advanced esophageal cancer (LAEC). This study aims to elucidate the prognostic role of PET/CT for patients treated with neoadjuvant chemoradiation (CRT) followed by esophagectomy. Methods: We retrospectively evaluated patients with LAEC treated from 2006 to 2014 with neoadjuvant CRT followed by esophagectomy. 86 patients had pre-CRT and post CRT PET/CT scans performed at our institution. These scans were imported into an image analysis program. PET parameters maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), mean standardized uptake value (SUVmean), and peak standardized uptake value (SUVpeak) were recorded for both pre-CRT and post-CRT scans. MTV was defined using a previously described liver method. The correlation of these parameters with pathologic complete response (pCR) and clinical outcomes was analyzed using binomial logistic regression and cox regression. Results: Pre-CRT MTV < 33.6 (median value) was significantly predictive of pCR (p = 0.019, OR = 3.064). An ROC curve was produced to determine a binary cutoff of 35.8, yielding a higher specificity (62.3% vs. 59%) and the same sensitivity (72.7%), increasing the significance to p = 0.010, OR = 3.378. The ratio of postMTV/preMTV (MTVr) was calculated. MTVr > 0.2857 (median value) was significantly predictive of distant metastasis (DM) after esophagectomy (p = 0.018, OR = 3.680). An ROC curve was produced to determine a binary cutoff of 0.301, which increased specificity from 57.1% to 60.3%, and maintained the same sensitivity at 81.3%, increasing the significance to p = 0.014, OR = 3.815. SUVmax, mean and peak were not predictive. Conclusions: Pre CRT MTV was predictive of pCR and MTVr was predictive of DM. Our data suggests that MTV is superior to SUVmax, mean and peak in predicting for response to treatment in LAEC. Further study is needed to determine if Pre CRT MTV and change in MTV can help define which patients will most benefit from esophagectomy and/ or adjuvant chemotherapy.

RA07.01: CHANGE OF METABOLIC TUMOR VOLUME PREDICTS LONG-TERM SURVIVAL AND HISTOLOGICAL RESPONSE TO PREOPERATIVE CHEMOTHERAPY IN LOCALLY-ADVANCED ESOPHAGEAL CANCER

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 34-34
Author(s):  
Tomoki Makino ◽  
Makoto Yamasaki ◽  
Koji Tanaka ◽  
Yasunori Masuike ◽  
Masaki Mori ◽  
...  
Keyword(s):  
Preoperative Chemotherapy ◽  
Tumor Volume ◽  
Locally Advanced ◽  
Reduction Rate ◽  
Metabolic Tumor Volume ◽  
Term Survival ◽  
Cutoff Value ◽  
Before And After ◽  
Locally Advanced Esophageal Cancer

Abstract Background The present study was aimed to assess the value of metabolic tumor volume (MTV) measured by 18F-fluorodeoxyglucose to evaluate response to neoadjuvant chemotherapy in patients with locally-advanced esophageal cancer (EC). Methods A total of 102 EC patients without distant metastasis who underwent 18-fluorodeoxyglucose (FDG)-positron emission tomography (PET) both before and after the series of preoperative chemotherapy were analyzed. Results The median value of MTV in primary tumor before and after preoperative chemotherapy were 22.55 (range: 0.4 -183.1) and 2.75 (0–52.9), respectively and the median reduction rate of MTV was 86.5%. The most significant difference in survival between PET responders and non-responders was at 60% of MTV reduction as a cutoff value based on every 10% stepwise cutoff analysis (2-year progression-free survival [PFS]: 79.2 vs 44.4%; hazard ratio [HR] = 3.397; P < 0.0001). With this cutoff value, histological complete response (P = 0.0091) in addition to tumor location (P = 0.0102), pT (P = 0.0011), and pN (P = 0.0110) were significantly associated with PET response. Univariate analysis of PFS indicated a correlation between PFS and tumor size, cT, decrease of primary lesion by CT, SUVmax reduction rate, MTV reduction rate, pT, pN, pM. Multivariate analysis further identified MTV reduction rate (HR = 2.471; P = 0.0263) but not decrease of primary lesion by CT or SUVmax reduction rate to be independent prognostic predictors along with pM (HR = 3.063; P = 0.0279). Conclusion By determining the optimal cutoff value based on survival analysis, change of MTV was shown to be clinically useful in predicting both long-term survival and histological response to preoperative chemotherapy in EC patients. Disclosure All authors have declared no conflicts of interest.

scholarly journals Long-term survival after esophagectomy with distal pancreatectomy for locally advanced esophageal cancer with pancreatic invasion: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Yoshiki Kaneko ◽  
Katsuji Hisakura ◽  
Koichi Ogawa ◽  
Yoshimasa Akashi ◽  
Yusuke Ohara ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Distal Pancreatectomy ◽  
Locally Advanced ◽  
Gastric Mucosal Damage ◽  
Advanced Esophageal Cancer ◽  
Term Survival ◽  
Long Term Survival ◽  
Pancreatic Invasion ◽  
Locally Advanced Esophageal Cancer

Abstract Background The treatment for the locally advanced esophageal cancer invading adjacent organs is controversial. We performed a radical surgery for a patient suffering from lower esophageal cancer with pancreatic invasion, and led to long-term survival. Case presentation A 62-year-old man with dysphagia, was endoscopically diagnosed lower esophageal cancer. Abdominal computed tomography shows that the tumor formed a mass with the solitary metastatic abdominal lymph node, which invaded pancreas body and gastric body. He was diagnosed locally advanced esophageal cancer cStage IIIC. As chemoradiotherapy was difficult because of the high risk of gastric mucosal damage, radical esophagectomy with distal pancreatectomy and reconstruction of gastric conduit were performed. The postoperative course was uneventful and the patient was discharged 16 days after operation. At present, 7 years after surgery, he is still alive with disease-free condition. Conclusion Esophagectomy with distal pancreatectomy may be feasible for locally advanced esophageal cancer with pancreatic invasion in terms of curability and long-term survival.

Prognostic analysis of esophageal squamous cell cancer patients who received neoadjuvant chemoradiotherapy combined with surgery.

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 97-97
Author(s):  
Xue Li ◽  
Daxuan Hao ◽  
Yuanyuan Yang ◽  
Yougai Zhang ◽  
Xiaoyuan Wu ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Prognostic Factors ◽  
Squamous Cell Cancer ◽  
Cell Cancer ◽  
Locally Advanced ◽  
Neoadjuvant Chemoradiotherapy ◽  
Advanced Esophageal Cancer ◽  
Term Survival ◽  
Locally Advanced Esophageal Cancer

97 Background: The neoadjuvant chemoradiotherapy (nCRT) combined with surgery is hopeful to improve the prognosis of locally advanced esophageal cancer but it remains contentious. Several studies showed that nCRT could significantly improve 5-year OS rate of locally advanced esophageal cancer. However, other clinical trials did not come to the same conclusion. This study retrospectively analyzed the esophageal squamous cell cancer (ESCC) patients who received nCRT combined with surgery in our hospital to investigate the prognostic factors for the patients’ survival. Methods: 96 patients with ESCC who received nCRT combined with surgery in our hospital from January 2007 to December 2014 were retrospectively analyzed. They were diagnosed with preoperation stage T3-4N0-1M0. Among them, 34 cases were in stage IIc and 62 cases were in stage IIIc. Prognostic factors for these patients were analyzed. Results: 26 (27.1%) patients received pathologic complete response (pCR) and 80 (83.3%) patients had downstage. The 1-, 3-, 5-year OS rates of all patients were 91.5%, 63.5%, 55.1%. The 1-, 3-, 5-year OS rates of tumor regression grading(TRG) 1, 2, 3 were 88.9%, 54.1%, 36.5% vs 88.4%, 56.4%, 48.6% vs 95.5%, 90.4%, 90.4%(Р = 0.014). The 1-, 3-, 5-year OS rates of pCR and non-pCR were 95.5%, 90.4%, 90.4% vs 88.6%, 55.6%, 45.4%(Р = 0.004). The 1-, 3-, 5-year OS rates of pathological lymph node negative(ypN-) and positive(ypN+) were 97.3%, 71.1%, 59.8% vs 66.7%, 33.3%, 33.3%(Р = 0.002). The 1-, 3-, 5-year OS rates of downstage and no-downstage were 94.9%, 73.9%, 65.6% vs 75.0%, 18.8%, 12.5% (Р = 0.000). Multivariate analyses identified pathologic lymph nodal status (RR = 2.193, 95%CI:1.018-4.726, Р = 0.045) and downstage category (RR = 3.520, 95%CI:1.638-7.568, Р = 0.001) were significant independent prognostic parameters. Conclusions: The nCRT combined with surgery achieved a high rate of long-term survival without increasing postoperative complications in patients with locally advanced ESCC. TRG was closely associated with patient’s prognosis, especially for patients with pCR. Pathologic lymph nodal status and downstage category were independent influencing factors for long-term survival.

Impact of low skeletal muscle mass and density on outcomes of locally advanced esophageal cancer patients treated with radical radiotherapy.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e16047-e16047
Author(s):  
Jiahua Lv ◽  
Ningjing Yang ◽  
Hongyuan Jia ◽  
Long Liang ◽  
Lei Wu ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Esophageal Cancer ◽  
Muscle Mass ◽  
Skeletal Muscle Mass ◽  
Locally Advanced ◽  
Radical Radiotherapy ◽  
Advanced Esophageal Cancer ◽  
Term Survival ◽  
Locally Advanced Esophageal Cancer

e16047 Background: Low skeletal muscle mass and density are independent predictors of clinical outcomes in multiple gastrointestinal cancers. However, its effect on the long-term survival of locally advanced esophageal cancer patients undergoing radical radiotherapy is still unclear. Methods: Patients with stage II-III esophageal cancer undergoing radical radiotherapy, enrolled in a observational cohort study, were included. Skeletal muscle mass and density were measured on CT. Patients with high and low skeletal muscle mass and density were compared regarding overall survival (OS). Results: In total, 165 patients (75.8% males, median age 63) were included, from March 2012 to September 2017. Before radiotherapy, 26.7% patients had low skeletal muscle mass and 23.0% patients had low skeletal muscle density. After radiotherapy, 40.6% patients had low skeletal muscle mass and 30.3% patients had low skeletal muscle density.The median OS of high skeletal muscle mass and density group was significantly higher than that of low skeletal muscle mass and density group before radiotherapy (28.7 months vs 28.2 months, p = 0.041; 29.6 months vs 16.9 months, p = 0.025). The median OS of high skeletal muscle mass and density group was also significantly higher than that of low skeletal muscle mass and density group after radiotherapy (30.3 months vs 20.3 months, P = 0.012; 29.6 months vs 17.2 months, p = 0.018). Conclusions: Low skeletal muscle mass and density are associated with long-term outcome in patients undergoing radical radiotherapy. It is suggested that oncologists should pay more attention to the management of muscle mass and density of patients with esophageal cancer undergoing radiotherapy in order to improve their nutritional status and long-term survival.

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