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Journal of Gastrointestinal Surgery
Erschienen in: Journal of Gastrointestinal Surgery 5/2014

01.05.2014 | Original Article

A Systematic Review of the Predictive Value of 18FDG-PET in Esophageal and Esophagogastric Junction Cancer After Neoadjuvant Chemoradiation on the Survival Outcome Stratification

verfasst von: Pascaline Schollaert, Ralph Crott, Claude Bertrand, Lionel D’Hondt, Thierry Vander Borght, Bruno Krug

Erschienen in: Journal of Gastrointestinal Surgery | Ausgabe 5/2014

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Abstract

Purpose

We studied the predictive value of [18 F]fluorodeoxyglucose-positron emission tomography (18FDG-PET) for assessing disease-free (DFS) and overall survival (OS) in esophageal and esophagogastric junction cancer.

Materials and methods

A literature search (PUBMED/MEDLINE, EMBASE, Cochrane) was performed to identify full papers with 18FDG-PET and survival data, using indexing terms and free text words. Studies with >10 patients with locally advanced esophageal cancer, presenting sequential or at least one post-adjuvant treatment 18FDG-PET data and Kaplan–Meier survival curves with >6 months median follow-up period were included. We performed a meta-analysis for DFS and OS using the hazard ratio (HRs) as outcome measure. Sources of heterogeneity study were also explored.

Results

We identified 26 eligible studies including a total of 1,544 patients (average age 62 years, 82 % males). The TNM distribution was as follows: stage I 7 %, II 24 %, III 53 % and IV 15 %. The pooled HRs for complete metabolic response versus no response were 0.51 for OS (95 % CI, 0.4–0.64; P < 0.00001) and 0.47 for DFS (95 % CI, 0.38–0.57; P < 0.00001), respectively. No statistical heterogeneity was present. To explore sources of clinical heterogeneity, we also realised subgroup and regression analyses. Taken into account the moderate correlation between OS and DFS (ρ = 0.54), we used joint bivariate random regression model. These analyses did not show a statistically significant impact of study characteristics and PET modalities on the pooled outcome estimates.

Conclusion

Despite methodological and clinical heterogeneity, metabolic response on 18FDG-PET is a significant predictor of long-term survival data.
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Metadaten
Titel
A Systematic Review of the Predictive Value of 18FDG-PET in Esophageal and Esophagogastric Junction Cancer After Neoadjuvant Chemoradiation on the Survival Outcome Stratification
verfasst von
Pascaline Schollaert
Ralph Crott
Claude Bertrand
Lionel D’Hondt
Thierry Vander Borght
Bruno Krug
Publikationsdatum
01.05.2014
Verlag
Springer US
Erschienen in
Journal of Gastrointestinal Surgery / Ausgabe 5/2014
Print ISSN: 1091-255X
Elektronische ISSN: 1873-4626
DOI
https://doi.org/10.1007/s11605-014-2488-2

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