nach oben

European Journal of Nuclear Medicine and Molecular Imaging

Erschienen in:

08.08.2021 | Original Article

Trimodality therapy for locally advanced esophageal squamous cell carcinoma: the role of volume-based PET/CT in patient management and prognostication

verfasst von: Yeonu Choi, Joon Young Choi, Tae Hee Hong, Yoon-La Choi, Dongryul Oh, Sook Young Woo, Young Mog Shim, Jae Ill Zo, Hong Kwan Kim, Kyung Soo Lee

Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging | Ausgabe 2/2022

Einloggen, um Zugang zu erhalten

Abstract

Purpose

To evaluate the role of positron emission tomography/computed tomography (PET/CT) in predicting pathologic complete response (pCR) and identify relevant prognostic factors from clinico-imaging-pathologic features of locally advanced esophageal squamous cell carcinoma (eSCC) patients undergoing trimodality therapy.

Methods

We evaluated 275 patients with eSCCs of T3-T4aN0M0 and T1-T4aN1-N3M0 who received trimodality therapy. We correlated volume-based PET/CT parameters before and after concurrent chemoradiation therapy with pCR after surgery, clinico-imaging-pathologic features, and patient survival.

Results

pCR occurred in 75 (27.3%) of 275 patients, of whom 61 (80.9%) showed 5-year survival. Pre-total lesion glycolysis (pre-TLG, OR = 0.318, 95% CI 0.169 to 0.600), post-metabolic tumor volume (post-MTV, OR = 0.572, 95% CI 0.327 to 0.999), and % decrease of average standardized uptake value (% SUVavg decrease, OR = 2.976, 95% CI = 1.608 to 5.507) were significant predictors for pCR. Among them, best predictor for pCR was pre-TLG with best cutoff value of 205.67 and with AUC value of 0.591.

Performance status (HR = 5.171, 95% CI 1.737 to 15.397), pathologic tumor size (HR = 1.645, 95% CI 1.351 to 2.002), pathologic N status (N1, HR = 1.572, 95% CI 1.010 to 2.446; N2, HR = 3.088, 95% CI 1.845 to 5.166), and post-metabolic tumor volume (HR = 1.506, 95% CI 1.033 to 2.195) were significant predictors of overall survival.

Conclusion

Pre-TLG, post-MTV, and % SUVavg decrease are predictive of pCR. Additionally, several clinico-imaging-pathologic factors are significant survival predictors in locally advanced eSCC patients undergoing trimodality therapy.

Nur mit Berechtigung zugänglich

Jeong DY, Kim MY, Lee KS, et al. Surgically resected T1- and T2-stage esophageal squamous cell carcinoma: T and N staging performance of EUS and PET/CT. Cancer Med. 2018;7(8):3561–70. https://doi.org/10.1002/cam4.1617.CrossRefPubMedPubMedCentral

Jeong DY, Lee KS, Choi JY, et al. Surgically resected esophageal squamous cell carcinoma: patient survival and clinicopathological prognostic factors. Sci Rep. 2020;10(1):5077. https://doi.org/10.1038/s41598-020-62028-5.CrossRefPubMedPubMedCentral

Huang YC, Lu HI, Huang SC, et al. FDG PET using SUVmax for preoperative T-staging of esophageal squamous cell carcinoma with and without neoadjuvant chemoradiotherapy. BMC Med Imaging. 2017;17(1):1. https://doi.org/10.1186/s12880-016-0171-7.CrossRefPubMedPubMedCentral

Chuang HH, Macapinlac HA. The evolving role of PET-CT in the management of esophageal cancer. Q J Nucl Med Mol Imaging. 2009;53(2):201–9.PubMed

Gebski V, Burmeister B, Smithers BM, et al. Survival benefits from neoadjuvant chemoradiotherapy or chemotherapy in oesophageal carcinoma: a meta-analysis. Lancet Oncol. 2007;8(3):226–34. https://doi.org/10.1016/S1470-2045(07)70039-6.CrossRefPubMed

Tepper J, Krasna MJ, Niedzwiecki D, et al. Phase III trial of trimodality therapy with cisplatin, fluorouracil, radiotherapy, and surgery compared with surgery alone for esophageal cancer: CALGB 9781. J Clin Oncol. 2008;26(7):1086–92. https://doi.org/10.1200/JCO.2007.12.9593.CrossRefPubMed

Bollschweiler E, Metzger R, Drebber U, et al. Histological type of esophageal cancer might affect response to neo-adjuvant radiochemotherapy and subsequent prognosis. Ann Oncol. 2009;20(2):231–8. https://doi.org/10.1093/annonc/mdn622.CrossRefPubMed

Connors RC, Reuben BC, Neumayer LA, Bull DA. Comparing outcomes after transthoracic and transhiatal esophagectomy: a 5-year prospective cohort of 17,395 patients. J Am Coll Surg. 2007;205(6):735–40. https://doi.org/10.1016/j.jamcollsurg.2007.07.001.CrossRefPubMed

Chang AC, Ji H, Birkmeyer NJ, Orringer MB, Birkmeyer JD. Outcomes after transhiatal and transthoracic esophagectomy for cancer. Ann Thorac Surg. 2008;85(2):424–9. https://doi.org/10.1016/j.athoracsur.2007.10.007.CrossRefPubMed

10.

Depypere L, Thomas M, Moons J, et al. Analysis of patients scheduled for neoadjuvant therapy followed by surgery for esophageal cancer, who never made it to esophagectomy. World J Surg Oncol. 2019;17(1):89. https://doi.org/10.1186/s12957-019-1630-8.CrossRefPubMedPubMedCentral

11.

Arnett ALH, Merrell KW, Macintosh EM, et al. Utility of (18)F-FDG PET for predicting histopathologic response in esophageal carcinoma following chemoradiation. J Thorac Oncol. 2017;12(1):121–8. https://doi.org/10.1016/j.jtho.2016.08.136.CrossRefPubMed

12.

Elimova E, Wang X, Etchebehere E, et al. 18-fluorodeoxy-glucose positron emission computed tomography as predictive of response after chemoradiation in oesophageal cancer patients. Eur J Cancer. 2015;51(17):2545–52. https://doi.org/10.1016/j.ejca.2015.07.044.CrossRefPubMedPubMedCentral

13.

Song SY, Kim JH, Ryu JS, et al. FDG-PET in the prediction of pathologic response after neoadjuvant chemoradiotherapy in locally advanced, resectable esophageal cancer. Int J Radiat Oncol Biol Phys. 2005;63(4):1053–9. https://doi.org/10.1016/j.ijrobp.2005.03.033.CrossRefPubMed

14.

Li Y, Zschaeck S, Lin Q, Chen S, Chen L, Wu H. Metabolic parameters of sequential 18F-FDG PET/CT predict overall survival of esophageal cancer patients treated with (chemo-) radiation. Radiat Oncol. 2019;14(1):35. https://doi.org/10.1186/s13014-019-1236-x.CrossRefPubMedPubMedCentral

15.

Hyun SH, Ahn HK, Ahn MJ, et al. Volume-based assessment with 18F-FDG PET/CT improves outcome prediction for patients with stage IIIA-N2 non-small cell lung cancer. AJR Am J Roentgenol. 2015;205(3):623–8. https://doi.org/10.2214/ajr.14.13847.CrossRefPubMed

16.

Hamai Y, Hihara J, Emi M, et al. Ability of fluorine-18 fluorodeoxyglucose positron emission tomography to predict outcomes of neoadjuvant chemoradiotherapy followed by surgical treatment for esophageal squamous cell carcinoma. Ann Thorac Surg. 2016;102(4):1132–9. https://doi.org/10.1016/j.athoracsur.2016.04.011.CrossRefPubMed

17.

Blum Murphy M, Xiao L, Patel VR, et al. Pathological complete response in patients with esophageal cancer after the trimodality approach: the association with baseline variables and survival-The University of Texas MD Anderson Cancer Center experience. Cancer. 2017;123(21):4106–13. https://doi.org/10.1002/cncr.30953.CrossRefPubMed

18.

Kurokawa T, Hamai Y, Emi M, et al. Risk factors for recurrence in esophageal squamous cell carcinoma without pathological complete response after trimodal therapy. Anticancer Res. 2020;40(8):4387–94. https://doi.org/10.21873/anticanres.14442.CrossRefPubMed

19.

Khan M, Urooj N, Syed AA, et al. Prognostic factors for recurrence in esophageal cancer patients treated with neoadjuvant therapy and surgery: a single-institution analysis. Cureus. 2020;12(5): e8108. https://doi.org/10.7759/cureus.8108.CrossRefPubMedPubMedCentral

20.

Tu CC, Hsu PK, Chien LI, et al. Prognostic histological factors in patients with esophageal squamous cell carcinoma after preoperative chemoradiation followed by surgery. BMC Cancer. 2017;17(1):62. https://doi.org/10.1186/s12885-017-3063-5.CrossRefPubMedPubMedCentral

21.

Stahl M, Lehmann N, Walz MK, Stuschke M, Wilke H. Prediction of prognosis after trimodal therapy in patients with locally advanced squamous cell carcinoma of the oesophagus. Eur J Cancer. 2012;48(16):2977–82. https://doi.org/10.1016/j.ejca.2012.03.010.CrossRefPubMed

22.

Hamai Y, Hihara J, Emi M, et al. Evaluation of prognostic factors for esophageal squamous cell carcinoma treated with neoadjuvant chemoradiotherapy followed by surgery. World J Surg. 2018;42(5):1496–505. https://doi.org/10.1007/s00268-017-4283-1.CrossRefPubMed

23.

Lee HY, Hyun SH, Lee KS, et al. Volume-based parameter of 18)F-FDG PET/CT in malignant pleural mesothelioma: prediction of therapeutic response and prognostic implications. Ann Surg Oncol. 2010;17(10):2787–94. https://doi.org/10.1245/s10434-010-1107-z.CrossRefPubMed

24.

Shim SS, Lee KS, Kim BT, et al. Non-small cell lung cancer: prospective comparison of integrated FDG PET/CT and CT alone for preoperative staging. Radiology. 2005;236(3):1011–9. https://doi.org/10.1148/radiol.2363041310.CrossRefPubMed

25.

Lee JY, Kim YH, Park YJ, et al. Improved detection of metastatic lymph nodes in oesophageal squamous cell carcinoma by combined interpretation of fluorine-18-fluorodeoxyglucose positron-emission tomography/computed tomography. Cancer Imaging. 2019;19(1):40. https://doi.org/10.1186/s40644-019-0225-5.CrossRefPubMedPubMedCentral

26.

Korst RJ, Rusch VW, Venkatraman E, et al. Proposed revision of the staging classification for esophageal cancer. J Thorac Cardiovasc Surg. 1998;115(3):660–669; discussion 669–670. https://doi.org/10.1016/s0022-5223(98)70332-0

27.

Rice TW, Blackstone EH, Rusch VW. 7th edition of the AJCC Cancer Staging Manual: esophagus and esophagogastric junction. Ann Surg Oncol. 2010;17(7):1721–4. https://doi.org/10.1245/s10434-010-1024-1.CrossRefPubMed

28.

Mandard AM, Dalibard F, Mandard JC, et al. Pathologic assessment of tumor regression after preoperative chemoradiotherapy of esophageal carcinoma. Clinicopathologic correlations. Cancer. 1994;73(11):2680–6. https://doi.org/10.1002/1097-0142(19940601)73:11%3c2680::aid-cncr2820731105%3e3.0.co;2-c.CrossRefPubMed

29.

Kaplan ELMP. Nonparametric-estimation from incomplete observations. J Am Stat Assoc. 1958;53(282):457–81. https://doi.org/10.1080/01621459.1958.10501452.CrossRef

30.

Kock NLGS. Lateral collinearity and misleading results in variance-based SEM: an illustration and recommendations. J Assoc Inf Syst. 2012;13(7):546–80.

31.

Schoenfeld DA. Partial residuals for the proportional hazards regression model. Biometrika. 1982;69:239–41.CrossRef

32.

Lin DY, Wei LJ, Ying Z. Checking the Cox model with cumulative sums of martingale-based residuals. Biometrika. 1993;80:557–72.CrossRef

33.

Miller RaS D. Maximally selected chi square statistics. Biometrics. 1982;38:1011–6.CrossRef

34.

Contal C, O’Quigley J. An application of changepoint methods in studying the effect of age on survival in breast cancer. Comput Stat Data Anal. 1999;30:253–70.CrossRef

35.

Shapiro J, van Lanschot JJB, Hulshof M, et al. Neoadjuvant chemoradiotherapy plus surgery versus surgery alone for oesophageal or junctional cancer (CROSS): long-term results of a randomised controlled trial. Lancet Oncol. 2015;16(9):1090–8. https://doi.org/10.1016/s1470-2045(15)00040-6.CrossRefPubMed

36.

Sjoquist KM, Burmeister BH, Smithers BM, et al. Survival after neoadjuvant chemotherapy or chemoradiotherapy for resectable oesophageal carcinoma: an updated meta-analysis. Lancet Oncol. 2011;12(7):681–92. https://doi.org/10.1016/s1470-2045(11)70142-5.CrossRefPubMed

37.

van Hagen P, Hulshof MC, van Lanschot JJ, et al. Preoperative chemoradiotherapy for esophageal or junctional cancer. N Engl J Med. 2012;366(22):2074–84. https://doi.org/10.1056/NEJMoa1112088.CrossRefPubMed

38.

Bedenne L, Michel P, Bouché O, et al. Chemoradiation followed by surgery compared with chemoradiation alone in squamous cancer of the esophagus: FFCD 9102. J Clin Oncol. 2007;25(10):1160–8. https://doi.org/10.1200/jco.2005.04.7118.CrossRefPubMed

39.

Stahl M, Stuschke M, Lehmann N, et al. Chemoradiation with and without surgery in patients with locally advanced squamous cell carcinoma of the esophagus. J Clin Oncol. 2005;23(10):2310–7. https://doi.org/10.1200/jco.2005.00.034.CrossRefPubMed

40.

Valkema MJ, Noordman BJ, Wijnhoven BPL, et al. Accuracy of (18)F-FDG PET/CT in predicting residual disease after neoadjuvant chemoradiotherapy for esophageal cancer. J Nucl Med. 2019;60(11):1553–9. https://doi.org/10.2967/jnumed.118.224196.CrossRefPubMed

41.

Hamai Y, Emi M, Ibuki Y, et al. Predictions of pathological features and recurrence based on FDG-PET Findings of esophageal squamous cell carcinoma after trimodal therapy. Ann Surg Oncol. 2020. https://doi.org/10.1245/s10434-020-08609-0.CrossRefPubMed

42.

Borggreve AS, Goense L, van Rossum PSN, et al. Preoperative prediction of pathologic response to neoadjuvant chemoradiotherapy in patients with esophageal cancer using (18)F-FDG PET/CT and DW-MRI: a prospective multicenter study. Int J Radiat Oncol Biol Phys. 2020;106(5):998–1009. https://doi.org/10.1016/j.ijrobp.2019.12.038.CrossRefPubMedPubMedCentral

43.

Alnaji RM, Du W, Gabriel E, et al. Pathologic complete response is an independent predictor of improved survival following neoadjuvant chemoradiation for esophageal adenocarcinoma. J Gastrointest Surg. 2016;20(9):1541–6. https://doi.org/10.1007/s11605-016-3177-0.CrossRefPubMed

44.

Berger AC, Farma J, Scott WJ, et al. Complete response to neoadjuvant chemoradiotherapy in esophageal carcinoma is associated with significantly improved survival. J Clin Oncol. 2005;23(19):4330–7. https://doi.org/10.1200/jco.2005.05.017.CrossRefPubMed

45.

de Gouw D, Klarenbeek BR, Driessen M, et al. Detecting pathological complete response in esophageal cancer after neoadjuvant therapy based on imaging techniques: a diagnostic systematic review and meta-analysis. J Thorac Oncol. 2019;14(7):1156–71. https://doi.org/10.1016/j.jtho.2019.04.004.CrossRefPubMed

46.

Bedenne L. MC. Comparison of systematic surgery versus surveillance and rescue surgery in operable oesophageal cancer with a complete clinical response to radiochemotherapy (esostrate).https://clinicaltrials.gov/ct2/show/NCT02551458.

47.

Noordman BJ, Wijnhoven BPL, Lagarde SM, et al. Neoadjuvant chemoradiotherapy plus surgery versus active surveillance for oesophageal cancer: a stepped-wedge cluster randomised trial. BMC Cancer. 2018;18(1):142. https://doi.org/10.1186/s12885-018-4034-1.CrossRefPubMedPubMedCentral

48.

Guo JC, Huang TC, Lin CC, et al. Postchemoradiotherapy pathologic stage classified by the American Joint Committee on the Cancer Staging System predicts prognosis of patients with locally advanced esophageal squamous cell carcinoma. J Thorac Oncol. 2015;10(10):1481–9. https://doi.org/10.1097/jto.0000000000000651.CrossRefPubMed

49.

O JH, Jacene H, Luber B, et al. Quantitation of cancer treatment response by (18)F-FDG PET/CT: multicenter assessment of measurement variability. J Nucl Med. 2017;58(9):1429–1434. https://doi.org/10.2967/jnumed.117.189605

Titel: Trimodality therapy for locally advanced esophageal squamous cell carcinoma: the role of volume-based PET/CT in patient management and prognostication
verfasst von: Yeonu Choi
Joon Young Choi
Tae Hee Hong
Yoon-La Choi
Dongryul Oh
Sook Young Woo
Young Mog Shim
Jae Ill Zo
Hong Kwan Kim
Kyung Soo Lee
Publikationsdatum: 08.08.2021
Verlag: Springer Berlin Heidelberg
Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging / Ausgabe 2/2022
Print ISSN: 1619-7070
Elektronische ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-021-05487-w

Live-Webinar "Chronische Unterbauch- und Viszeralschmerzen in der Praxis managen"

Springer Medizin

Trimodality therapy for locally advanced esophageal squamous cell carcinoma: the role of volume-based PET/CT in patient management and prognostication

Abstract

Purpose

Methods

Results

Conclusion

Live-Webinar "Chronische Unterbauch- und Viszeralschmerzen in der Praxis managen"

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusion

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 2/2022

Whole-body uptake classification and prostate cancer staging in 68Ga-PSMA-11 PET/CT using dual-tracer learning

A 3D deep learning model to predict the diagnosis of dementia with Lewy bodies, Alzheimer’s disease, and mild cognitive impairment using brain 18F-FDG PET

CXCR4 expression in glioblastoma tissue and the potential for PET imaging and treatment with [68Ga]Ga-Pentixafor /[177Lu]Lu-Pentixather

EANM procedure guidelines for brain PET imaging using [18F]FDG, version 3

Intra-therapeutic dosimetry of [177Lu]Lu-PSMA-617 in low-volume hormone-sensitive metastatic prostate cancer patients and correlation with treatment outcome

A radioiodinated FR-β-targeted tracer with improved pharmacokinetics through modification with an albumin binder for imaging of macrophages in AS and NAFL