Prognostic value of quantitative parameters for esophageal squamous cell carcinoma determined by preoperative FDG-PET after trimodal therapy
Prognostic value of quantitative parameters for esophageal squamous cell carcinoma determined by preoperative FDG-PET after trimodal therapy
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术前FDG-PET三模式治疗后定量参数测定食管鳞癌的预后价值
DOI：
10.1016/j.surg.2022.03.034
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发表时间：
2022
期刊：
影响因子：
3.8
通讯作者：
Okada M.
中科院分区：
文献类型：
--
作者：
Hamai Y;Emi M;Ibuki Y;Murakami Y;Nishibuchi I;Nagata Y;Kurokawa T;Yoshikawa T;Hirohata R;Ohsawa M;Kitasaki N;Okada M.
背景通过术前18F-氟脱氧葡萄糖-正电子发射断层扫描确定的肿瘤代谢和体积参数与接受三联疗法的食管鳞状细胞癌患者的生存率之间的关系尚未得到充分研究。和总病变糖酵解在原发性肿瘤对18F-氟脱氧葡萄糖-120例食管鳞状细胞癌患者新辅助放化疗前后正电子发射断层扫描图像与生存率之间的关系，结果Δ最大标准化摄取值、Δ代谢肿瘤体积和Δ总病变糖酵解的最佳截止值被定义为统计学上产生新辅助放化疗良好和不良正电子发射断层扫描应答者的无复发生存率的最大差异（截止值分别为70%、85%和90%）。这些临界值显著分层了总生存期（Δ最大标准化摄取值，P= 0.004; Δ代谢肿瘤体积，P= 0.001; Δ总病变糖酵解，P<0.0001）。单因素分析显示，Δ最大标准化摄取值（风险比，0.50; 95%置信区间，0.32-0.79;P= .003），Δ代谢肿瘤体积（风险比，0.50; 95%置信区间，0.31-0.81;P= 0.004）和Δ总病变糖酵解（风险比，0.37; 95%置信区间，0.23-0.61;P<0.001）对无复发生存率有统计学意义。此外，Δ代谢肿瘤体积（风险比，0.45; 95%置信区间，0.27-0.76;P= .003）和Δ总病变糖酵解（危害比，0.37; 95%可信区间，0.22-0.63; P<0.001）是复发的独立因素-包括术前和病理因素在内的多变量分析中的自由生存率。结论与重要的病理预后因素一起，Δ代谢肿瘤体积和Δ总病变糖酵解对接受三联疗法的食管鳞癌患者有价值。因此，术前18F-氟脱氧葡萄糖-正电子发射断层扫描是一个有用的和非侵入性的诊断工具，可能有助于定制局部晚期食管鳞状细胞癌的最佳治疗。
BackgroundAssociations between tumor metabolic and volumetric parameters determined by preoperative18F-fluorodeoxyglucose–positron emission tomography and survival in patients with esophageal squamous cell carcinoma who underwent trimodal therapy have not been fully investigated.MethodsWe evaluated relationships between reductions in maximal standardized uptake value, metabolic tumor volume, and total lesion glycolysis in primary tumors on18F-fluorodeoxyglucose–positron emission tomography images between before and after neoadjuvant chemoradiotherapy and the survival of 120 patients with esophageal squamous cell carcinoma who underwent neoadjuvant chemoradiotherapy followed by surgery.ResultsThe optimal cutoffs of Δ maximal standardized uptake value, Δ metabolic tumor volume, and Δ total lesion glycolysis were defined to statistically yield the largest differences in recurrence-free survival for good and poor positron emission tomography responders to neoadjuvant chemoradiotherapy (cutoffs: 70%, 85%, and 90%, respectively). These cutoff values significantly stratified overall survival (Δ maximal standardized uptake value,P= .004; Δ metabolic tumor volume,P= .001; Δ total lesion glycolysis,P< .0001). Univariate analysis showed that Δ maximal standardized uptake value (hazard ratio, 0.50; 95% confidence interval, 0.32–0.79;P= .003), Δ metabolic tumor volume (hazard ratio, 0.50; 95% confidence interval, 0.31–0.81;P= .004), and Δ total lesion glycolysis (hazard ratio, 0.37; 95% confidence interval, 0.23–0.61;P< .001) were statistically significant for recurrence-free survival. Furthermore, Δ metabolic tumor volume (hazard ratio, 0.45; 95% confidence interval, 0.27–0.76;P= .003) and Δ total lesion glycolysis (hazard ratio, 0.37; 95% confidence interval, 0.22–0.63;P< .001) were independent factors for recurrence-free survival in multivariate analyses that included preoperative and pathological factors.ConclusionTogether with significant pathological prognostic factors, Δ metabolic tumor volume and Δ total lesion glycolysis were valuable for patients with esophageal squamous cell carcinoma who received trimodal therapy. Thus, preoperative18F-fluorodeoxyglucose–positron emission tomography is a useful and noninvasive diagnostic tool that might facilitate tailoring optimal therapies for locally advanced esophageal squamous cell carcinoma.