Original articleGeneral thoracicAbility of Fluorine-18 Fluorodeoxyglucose Positron Emission Tomography to Predict Outcomes of Neoadjuvant Chemoradiotherapy Followed by Surgical Treatment for Esophageal Squamous Cell Carcinoma
Section snippets
Patients
We started preoperative evaluations of patients with esophageal cancer using FDG-PET/ computed tomography (CT) during October 2006. For this study, we reviewed 111 consecutive patients with ESCC who were evaluated preoperatively before and after nCRT induction using FDG-PET/CT and who were treated by esophagectomy with R0 resection between October 2006 and April 2015. These data were extracted from our surgical database. The Institutional Review Board at Hiroshima University approved this study.
Effects of nCRT
The clinical evaluation of the effect of nCRT showed a complete response (CR) in 31 (27.9%) patients, a partial response (PR) in 75 (67.6%) patients, and stable disease in 5 patients (4.5%). None of the patients had progressive disease, because those with unresectable progressive disease during nCRT were excluded. The mean number (±SD) of dissected lymph nodes was 48 ± 21 in all patients, and this was not significantly different between patients with cT2 and cT3/4 (47 ± 25 versus 48 ± 20; p =
Comment
Studies of the ability of FDG-PET to predict responses to nCRT in patients with esophageal cancer are contradictory 8, 9, 10, 11, 12. Moreover, some studies that have focused exclusively on ESCC have been limited by relatively small samples 19, 20, 21, 22. To our knowledge, the present assessment of only patients with locally advanced ESCC who underwent nCRT with 40-Gy radiotherapy and subsequent uniform surgical treatment (transthoracic esophagectomy with lymph node dissection in at least the
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2022, Surgery (United States)Citation Excerpt :The degree of metabolic activity in tumor cells can be determined by 18F-fluorodeoxyglucose–positron emission tomography (FDG-PET), and thus tumor staging can be improved in patients with esophageal cancer.7,8 The maximal standardized uptake value (SUVmax) derived from preoperative FDG-PET that indicates the metabolic activity of primary tumors can differentiate pathological good and poor responders and can predict survival after neoadjuvant chemotherapy (NCT) or NCRT followed by surgery.7,9–11 Furthermore, FDG-PET can preoperatively predict the degree of aggressive tumor behavior in esophageal cancer.12
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2020, Clinical RadiologyCitation Excerpt :A further prospective study with a larger study population in arrangement with chemoradiotherapy regimen is recommended to validate the present results. Third, there were differences in reduction rate between pathological responders and PERCIST responders; however, in the present study, pathological responders (grade 2 or 3) were defined according to the previously reported criteria, and the criteria have been used for assessing tumour response in patients with oesophageal cancer treated by NACRT.22,23 In the present study, there was a significant correlation between pathological response and PERCIST (p<0.001).
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2018, Surgery (United States)Citation Excerpt :The Institutional Review Board at Hiroshima University approved this study. The NCRT comprised concurrent radiotherapy (40 Gy) and chemotherapy with 5-fluorouracil and either docetaxel or cisplatin or a combination of both, as described.5,8-10 The clinical responses of the primary tumors and LNs after NCRT were evaluated by CT, PET, and endoscopy at 3 to 7 weeks after NCRT.
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