BACKGROUND Although 18F- FDG PET/CT is validated in baseline workup of esophageal cancer to detect distant metastases, it remains underused in assessing local staging and biology of the primary tumor. This study aimed to evaluate the association between 18F- FDG PET/CT-derived parameters of esophageal cancer, and its clinico-pathological features and prognosis. METHODS All patients (n = 86) with esophageal adenocarcinoma or squamous cell cancer operated between 2005 and 2014 were analyzed. Linear regression was used to identify clinico-pathologic features of esophageal cancer associated with the tumor's maximal Standardized Uptake Value (SUVmax), Total Lesion Glycolysis (TLG) and Metabolic Tumor Volume (MTV). ROC curve analysis was performed to precise the optimal cutoff of each variable associated with a locally advanced (cT3/4) status, long-term survival and recurrence. Kaplan Meier curves and Cox regression were used for survival analyses. RESULTS High baseline SUVmax was associated with cT3/4 status and middle-third tumor location, TLG with a cT3/4 and cN+ status, whereas MTV only with active smoking. A cT3/4 status was significantly predicted by a SUVmax > 8.25 g/mL (p < 0.001), TLG > 41.7 (p < 0.001) and MTV > 10.70 cm3 (p < 0.01) whereas a SUVmax > 12.7 g/mL was associated with an early tumor recurrence and a poor disease-free survival (median 13 versus 56 months, p = 0.030), particularly in squamous cell cancer. CONCLUSIONS Baseline 18F- FDG PET/CT has a high predictive value of preoperative cT stage, as its parameters SUVmax, TLG and MTV can predict a locally advanced tumor with high accuracy. A SUVmax > 12.7 g/mL may herald early tumor recurrence and poor disease-free survival.

中文翻译：

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18F-FDG PET / CT衍生的参数可预测食道癌的临床分期和预后。

背景技术尽管18F-FDG PET / CT在食道癌的基线检查中已被证实可检测远处转移，但在评估原发灶的局部分期和生物学方面仍未得到充分利用。本研究旨在评估18F-FDG PET / CT衍生的食管癌参数与其临床病理特征和预后之间的关联。方法分析2005年至2014年间手术治疗的所有食管腺癌或鳞状细胞癌患者（n = 86）。线性回归用于确定食管癌的临床病理特征，其与肿瘤的最大标准摄取值（SUVmax），总病变糖酵解（TLG）和代谢性肿瘤体积（MTV）相关。进行了ROC曲线分析，以精确确定与局部提前（cT3 / 4）状态相关的每个变量的最佳截止值，长期生存和复发。Kaplan Meier曲线和Cox回归用于生存分析。结果高基线SUVmax与cT3 / 4状态和肿瘤中部位置相关，TLG与cT3 / 4和cN +状态相关，而MTV仅与主动吸烟有关。SUVmax> 8.25 g / mL（p <0.001），TLG> 41.7（p <0.001）和MTV> 10.70 cm3（p <0.01）可显着预测cT3 / 4状态，而SUVmax> 12.7 g / mL具有早期肿瘤复发和较差的无病生存期（中位13个月对56个月，p = 0.030），尤其是在鳞状细胞癌中。结论基线18F-FDG PET / CT具有术前cT分期的高预测价值，因为其参数SUVmax，TLG和MTV可以高精度预测局部晚期肿瘤。SUVmax> 12。