Nicolai, M.J. (Mathieu) (2018) Pathologic aggressiveness in curatively treatable esophageal cancer is more likely associated with local tumor enhancement than with the SUV derived from 18F-FDG-PET. thesis, Medicine.
Full text available on request.Abstract
Introduction: Standardized uptake value (SUV) derived from 18F-FDG-PET measures intra-tumoral FDG uptake and is used in prognosis of esophageal cancer (EC). Higher SUV is related to recurrent disease and poorer survival. Therefore, it could be related to tumor aggressiveness and pathologic features that contribute to this aggressiveness. This study assessed the association between SUV as a semi-quantitative parameter and pathologic features and survival, which could be useful in the decision-making of treatment. Patients and methods: Patients underwent curative intended treatment for stage T2-4N0-3M0 EC at baseline FDG-PET/CT in the University Medical Centre Groningen. Treatment consisted of primary surgery, possibly preceded by neoadjuvant chemoradiotherapy (nCRT). Primary outcomes were pathologic aggressive features (perineural invasion, lymphovascular invasion, ≥ 4 lymph node metastases and LN ratio > 0.2) and overall survival (OS), disease free survival (DFS). Baseline SUVmax/SUVpeak and ΔSUVmax/SUVpeak (percentage decrease of SUV after nCRT) were assessed. Analyses were performed in the whole study group, the nCRT group and the surgery-alone group. Results: 150 of the 176 patients were treated with nCRT followed by surgery. No association was found between SUV and pathologic aggressive features. Pathologic aggressiveness was often related to advanced T and N-stage, higher clinical tumor length and non-tumor free resection margins. SUV was not an independent prognostic factor for OS and DFS, whereas a higher clinical T-stage was. The surgery-alone group was too small for adequate survival analysis. Conclusion: In patients with advanced EC, pathologic aggressive features and survival were not associated with SUV, but with local tumor enhancement and involvement of the resection margins.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Supervisor: and Plukker, Prof. Dr. J. T. M. and Department of Surgical Oncology and University Medical Center Groningen and University of Groningen |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:58 |
| Last Modified: | 25 Jun 2020 10:58 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/1856 |
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