Utility of positron emission-computed tomography for predicting pathological response in resectable oesophageal squamous cell carcinoma after neoadjuvant chemoradiation
| Autor: | Jong-Mu Sun, Keunchil Park, Myung-Ju Ahn, Sung Won Lim, Ji Yun Lee, Young Mog Shim, Joon Young Choi, Dongryul Oh, Jae Il Zo |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty Esophageal Neoplasms medicine.medical_treatment Standardized uptake value Electrons 03 medical and health sciences 0302 clinical medicine Fluorodeoxyglucose F18 Positron Emission Tomography Computed Tomography medicine Humans Basal cell Positron emission Neoadjuvant therapy Receiver operating characteristic business.industry Cancer Reproducibility of Results General Medicine Chemoradiotherapy Esophageal cancer medicine.disease Neoadjuvant Therapy 030220 oncology & carcinogenesis Positron-Emission Tomography Quality of Life 030211 gastroenterology & hepatology Surgery Radiology Esophageal Squamous Cell Carcinoma Radiopharmaceuticals Cardiology and Cardiovascular Medicine business Esophagitis |
| Zdroj: | European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery. 58(5) |
| ISSN: | 1873-734X |
| Popis: | OBJECTIVES For patients with locally advanced oesophageal cancer, improved complete pathological response after neoadjuvant chemoradiation (nCRT) and the detrimental effects on the quality of life related to oesophagectomy have led to the need for a reliable method to select patients who have achieved complete pathological response and do not need surgery. The reliability of 18F-fluorodeoxyglucose positron emission–computed tomography (PET-CT) for predicting the pathological response after nCRT was evaluated. METHODS Patients with locally advanced oesophageal cancer who were treated with nCRT and oesophagectomy from July 2010 to February 2017 were analysed. On the post-nCRT PET-CT, a complete metabolic response was defined as all tumourous lesions demonstrating maximum standardized uptake value (SUVmax) ≤2.5. To minimize the effect of radiation-induced oesophagitis, complete metabolic response was also defined as no viable lesion distinguishable from the background with diffuse uptake. The sensitivity, specificity, positive predictive value and negative predictive value were analysed for SUVmax, [X]ΔSUVmax and %ΔSUVmax. RESULTS A total of 158 patients with oesophageal squamous cell carcinoma were analysed. The rate of complete pathological response was 27.8%, and that of complete metabolic response was 7.6%. The sensitivity, specificity, positive predictive value and negative predictive value based on SUVmax ≤2.5 and visual normalization were 95%, 14%, 74% and 50%, respectively. Analysis for [X]ΔSUVmax and %ΔSUVmax using the optimal cut-off values determined by the receiver operating characteristic curves did not show an improved predictive efficacy. CONCLUSIONS PET-CT is not a reliable tool for predicting pathological response. Patients diagnosed with resectable oesophageal cancer who underwent neoadjuvant therapy should not be exempt from surgery based on PET-CT results. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|