Prognostic Value of Lymph Node-To-Primary Tumor Standardized Uptake Value Ratio in Esophageal Squamous Cell Carcinoma Treated with Definitive Chemoradiotherapy
We aimed to investigate the prognostic value of the relative maximum standardized uptake value (SUV) of metastatic lymph node (LN) compared with that of primary tumor (SUV<sub>LN</sub> / SUV<sub>Tumor</sub>) based on a pretreatment [<sup>18</sup>F]-FDG PET/CT scan...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2020-03-01
|
| Series: | Cancers |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2072-6694/12/3/607 |
| _version_ | 1797706598187008000 |
|---|---|
| author | Chia-Hsin Lin Tsung-Min Hung Yu-Chuan Chang Chia-Hsun Hsieh Ming-Chieh Shih Shih-Ming Huang Chan-Keng Yang Ching-Fu Chang Sheng-Chieh Chan Wing-Keen Yap |
| author_facet | Chia-Hsin Lin Tsung-Min Hung Yu-Chuan Chang Chia-Hsun Hsieh Ming-Chieh Shih Shih-Ming Huang Chan-Keng Yang Ching-Fu Chang Sheng-Chieh Chan Wing-Keen Yap |
| author_sort | Chia-Hsin Lin |
| collection | DOAJ |
| description | We aimed to investigate the prognostic value of the relative maximum standardized uptake value (SUV) of metastatic lymph node (LN) compared with that of primary tumor (SUV<sub>LN</sub> / SUV<sub>Tumor</sub>) based on a pretreatment [<sup>18</sup>F]-FDG PET/CT scan in patients with clinically node-positive esophageal squamous cell carcinoma (cN+ ESCC) treated with definitive chemoradiotherapy (dCRT). We retrospectively evaluated cN+ ESCC patients who underwent a PET/CT scan before dCRT. Time-dependent receiver operating characteristics analysis was performed to identify the optimal cutoff value for SUV<sub>LN</sub> / SUV<sub>Tumor</sub>. Prognostic influences of SUV<sub>LN</sub> / SUV<sub>Tumor</sub> on distant metastasis-free survival (DMFS) and overall survival (OS) were evaluated using the Kaplan−Meier method and log-rank test for univariate analysis and Cox’s proportional hazards regression model for multivariate analysis. We identified 112 patients with newly diagnosed cN+ ESCC. After a median follow-up of 32.0 months, 50 (44.6%) patients had distant failure and 84 (75.0%) patients died. Patients with high SUV<sub>LN</sub> / SUV<sub>Tumor</sub> (≥ 0.39) experienced worse outcomes than low SUV<sub>LN</sub> / SUV<sub>Tumor</sub> (< 0.39) (two-year DMFS: 26% vs. 70%, p < 0.001; two-year OS: 21% vs. 48%, p = 0.001). Multivariate analysis showed that SUV<sub>LN</sub> / SUV<sub>Tumor</sub> was an independent prognostic factor for both DMFS (adjusted HR 2.24, 95% CI 1.34−3.75, <i>p</i> = 0.002) and OS (adjusted HR 1.61, 95% CI 1.03−2.53, <i>p</i> = 0.037). Pretreatment of SUV<sub>LN</sub> / SUV<sub>Tumor</sub> is a simple and useful marker for prognosticating DMFS and OS in cN+ ESCC patients treated with dCRT, which may help in tailoring treatment and designing future clinical trials. |
| first_indexed | 2024-03-12T05:54:40Z |
| format | Article |
| id | doaj.art-a04c66e300e641cb917cab5bceeb9875 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-12T05:54:40Z |
| publishDate | 2020-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-a04c66e300e641cb917cab5bceeb98752023-09-03T04:50:17ZengMDPI AGCancers2072-66942020-03-0112360710.3390/cancers12030607cancers12030607Prognostic Value of Lymph Node-To-Primary Tumor Standardized Uptake Value Ratio in Esophageal Squamous Cell Carcinoma Treated with Definitive ChemoradiotherapyChia-Hsin Lin0Tsung-Min Hung1Yu-Chuan Chang2Chia-Hsun Hsieh3Ming-Chieh Shih4Shih-Ming Huang5Chan-Keng Yang6Ching-Fu Chang7Sheng-Chieh Chan8Wing-Keen Yap9Department of Radiation Oncology, Chang Gung Memorial Hospital-Linkou Medical Center and Chang Gung University, 5 Fu-Shin Street, Kwei-Shan, 333 Taoyuan, TaiwanDepartment of Radiation Oncology, Chang Gung Memorial Hospital-Linkou Medical Center and Chang Gung University, 5 Fu-Shin Street, Kwei-Shan, 333 Taoyuan, TaiwanDepartment of Nuclear Medicine and Molecular Imaging Center, Chang Gung Memorial Hospital-Linkou Medical Center and Chang Gung University, 333 Taoyuan, TaiwanCirculating Tumor Cell Lab, Division of Medical Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital-Linkou Medical Center and Chang Gung University, 333 Taoyuan, TaiwanInstitute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, TaiwanDepartment of Radiation Oncology, Keelung Chang Gung Memorial Hospital,204 Keelung, TaiwanDivision of Hematology-Oncology, Department of Internal Medicine, Linkou Medical Center, Chang Gung Memorial Hospital, Kweishan, 333 Taoyuan, TaiwanDivision of Hematology-Oncology, Department of Internal Medicine, Linkou Medical Center, Chang Gung Memorial Hospital, Kweishan, 333 Taoyuan, TaiwanDepartment of Nuclear Medicine, Hualien Tzu-Chi Hospital, Buddhist Tzu-Chi Medical Foundation, 970 Hualien, TaiwanDepartment of Radiation Oncology, Chang Gung Memorial Hospital-Linkou Medical Center and Chang Gung University, 5 Fu-Shin Street, Kwei-Shan, 333 Taoyuan, TaiwanWe aimed to investigate the prognostic value of the relative maximum standardized uptake value (SUV) of metastatic lymph node (LN) compared with that of primary tumor (SUV<sub>LN</sub> / SUV<sub>Tumor</sub>) based on a pretreatment [<sup>18</sup>F]-FDG PET/CT scan in patients with clinically node-positive esophageal squamous cell carcinoma (cN+ ESCC) treated with definitive chemoradiotherapy (dCRT). We retrospectively evaluated cN+ ESCC patients who underwent a PET/CT scan before dCRT. Time-dependent receiver operating characteristics analysis was performed to identify the optimal cutoff value for SUV<sub>LN</sub> / SUV<sub>Tumor</sub>. Prognostic influences of SUV<sub>LN</sub> / SUV<sub>Tumor</sub> on distant metastasis-free survival (DMFS) and overall survival (OS) were evaluated using the Kaplan−Meier method and log-rank test for univariate analysis and Cox’s proportional hazards regression model for multivariate analysis. We identified 112 patients with newly diagnosed cN+ ESCC. After a median follow-up of 32.0 months, 50 (44.6%) patients had distant failure and 84 (75.0%) patients died. Patients with high SUV<sub>LN</sub> / SUV<sub>Tumor</sub> (≥ 0.39) experienced worse outcomes than low SUV<sub>LN</sub> / SUV<sub>Tumor</sub> (< 0.39) (two-year DMFS: 26% vs. 70%, p < 0.001; two-year OS: 21% vs. 48%, p = 0.001). Multivariate analysis showed that SUV<sub>LN</sub> / SUV<sub>Tumor</sub> was an independent prognostic factor for both DMFS (adjusted HR 2.24, 95% CI 1.34−3.75, <i>p</i> = 0.002) and OS (adjusted HR 1.61, 95% CI 1.03−2.53, <i>p</i> = 0.037). Pretreatment of SUV<sub>LN</sub> / SUV<sub>Tumor</sub> is a simple and useful marker for prognosticating DMFS and OS in cN+ ESCC patients treated with dCRT, which may help in tailoring treatment and designing future clinical trials.https://www.mdpi.com/2072-6694/12/3/607fdg-petprognosisesccchemoradiotherapyesophageal cancer |
| spellingShingle | Chia-Hsin Lin Tsung-Min Hung Yu-Chuan Chang Chia-Hsun Hsieh Ming-Chieh Shih Shih-Ming Huang Chan-Keng Yang Ching-Fu Chang Sheng-Chieh Chan Wing-Keen Yap Prognostic Value of Lymph Node-To-Primary Tumor Standardized Uptake Value Ratio in Esophageal Squamous Cell Carcinoma Treated with Definitive Chemoradiotherapy Cancers fdg-pet prognosis escc chemoradiotherapy esophageal cancer |
| title | Prognostic Value of Lymph Node-To-Primary Tumor Standardized Uptake Value Ratio in Esophageal Squamous Cell Carcinoma Treated with Definitive Chemoradiotherapy |
| title_full | Prognostic Value of Lymph Node-To-Primary Tumor Standardized Uptake Value Ratio in Esophageal Squamous Cell Carcinoma Treated with Definitive Chemoradiotherapy |
| title_fullStr | Prognostic Value of Lymph Node-To-Primary Tumor Standardized Uptake Value Ratio in Esophageal Squamous Cell Carcinoma Treated with Definitive Chemoradiotherapy |
| title_full_unstemmed | Prognostic Value of Lymph Node-To-Primary Tumor Standardized Uptake Value Ratio in Esophageal Squamous Cell Carcinoma Treated with Definitive Chemoradiotherapy |
| title_short | Prognostic Value of Lymph Node-To-Primary Tumor Standardized Uptake Value Ratio in Esophageal Squamous Cell Carcinoma Treated with Definitive Chemoradiotherapy |
| title_sort | prognostic value of lymph node to primary tumor standardized uptake value ratio in esophageal squamous cell carcinoma treated with definitive chemoradiotherapy |
| topic | fdg-pet prognosis escc chemoradiotherapy esophageal cancer |
| url | https://www.mdpi.com/2072-6694/12/3/607 |
| work_keys_str_mv | AT chiahsinlin prognosticvalueoflymphnodetoprimarytumorstandardizeduptakevalueratioinesophagealsquamouscellcarcinomatreatedwithdefinitivechemoradiotherapy AT tsungminhung prognosticvalueoflymphnodetoprimarytumorstandardizeduptakevalueratioinesophagealsquamouscellcarcinomatreatedwithdefinitivechemoradiotherapy AT yuchuanchang prognosticvalueoflymphnodetoprimarytumorstandardizeduptakevalueratioinesophagealsquamouscellcarcinomatreatedwithdefinitivechemoradiotherapy AT chiahsunhsieh prognosticvalueoflymphnodetoprimarytumorstandardizeduptakevalueratioinesophagealsquamouscellcarcinomatreatedwithdefinitivechemoradiotherapy AT mingchiehshih prognosticvalueoflymphnodetoprimarytumorstandardizeduptakevalueratioinesophagealsquamouscellcarcinomatreatedwithdefinitivechemoradiotherapy AT shihminghuang prognosticvalueoflymphnodetoprimarytumorstandardizeduptakevalueratioinesophagealsquamouscellcarcinomatreatedwithdefinitivechemoradiotherapy AT chankengyang prognosticvalueoflymphnodetoprimarytumorstandardizeduptakevalueratioinesophagealsquamouscellcarcinomatreatedwithdefinitivechemoradiotherapy AT chingfuchang prognosticvalueoflymphnodetoprimarytumorstandardizeduptakevalueratioinesophagealsquamouscellcarcinomatreatedwithdefinitivechemoradiotherapy AT shengchiehchan prognosticvalueoflymphnodetoprimarytumorstandardizeduptakevalueratioinesophagealsquamouscellcarcinomatreatedwithdefinitivechemoradiotherapy AT wingkeenyap prognosticvalueoflymphnodetoprimarytumorstandardizeduptakevalueratioinesophagealsquamouscellcarcinomatreatedwithdefinitivechemoradiotherapy |