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Xia L, Li X, Zhu J, Gao Z, Zhang J, Yang G, Wang Z. Prognostic value of baseline 18F-FDG PET/CT in patients with esophageal squamous cell carcinoma treated with definitive (chemo)radiotherapy. Radiat Oncol 2023; 18:41. [PMID: 36829219 PMCID: PMC9960216 DOI: 10.1186/s13014-023-02224-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 02/07/2023] [Indexed: 02/26/2023] Open
Abstract
PURPOSE To investigate the prognostic value of baseline 18F-FDG PET/CT in patients with esophageal squamous cell carcinoma (ESCC) treated with definitive (chemo)radiotherapy. METHODS A total of 98 ESCC patients with cTNM stage T1-4, N1-3, M0 who received definitive (chemo)radiotherapy after 18F-FDG PET/CT examination from December 2013 to December 2020 were retrospectively analyzed. Clinical factors included age, sex, histologic differentiation grade, tumor location, clinical stage, and treatment strategies. Parameters obtained by 18F-FDG PET/CT included SUVmax of primary tumor (SUVTumor), metabolic tumor volume (MTV), total lesion glycolysis (TLG), SUVmax of lymph node (SUVLN), PET positive lymph nodes (PLNS) number, the shortest distance between the farthest PET positive lymph node and the primary tumor in three-dimensional space after the standardization of the patient BSA (SDmax(LN-T)). Univariate and multivariate analysis was conducted by Cox proportional hazard model to explore the significant factors affecting overall survival (OS) and progression-free survival (PFS) in ESCC patients. RESULTS Univariate analysis showed that tumor location, SUVTumor, MTV, TLG, PLNS number, SDmax (LN-T) were significant predictors of OS and tumor location, and clinical T stage, SUVTumor, MTV, TLG, SDmax (LN-T) were significant predictors of PFS (all p < 0.1). Multivariate analysis showed that MTV and SDmax (LN-T) were independent prognostic factors for OS (HR = 1.018, 95% CI 1.006-1.031; p = 0.005; HR = 6.988, 95% CI 2.119-23.042; p = 0.001) and PFS (HR = 1.019, 95% CI 1.005-1.034; p = 0.009; HR = 5.819, 95% CI 1.921-17.628; p = 0.002). Combined with independent prognostic factors MTV and SDmax (LN-T), we can further stratify patient risk. CONCLUSIONS Before treatment, 18F-FDG PET/CT has important prognostic value for patients with ESCC treated with definitive (chemo)radiotherapy. The lower the value of MTV and SDmax (LN-T), the better the prognosis of patients.
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Affiliation(s)
- Lianshuang Xia
- grid.412521.10000 0004 1769 1119Department of Nuclear Medicine, The Affiliated Hospital of Qingdao University, Qingdao, Shandong China
| | - Xiaoxu Li
- grid.412521.10000 0004 1769 1119Department of Nuclear Medicine, The Affiliated Hospital of Qingdao University, Qingdao, Shandong China
| | - Jie Zhu
- grid.412521.10000 0004 1769 1119Department of Scientific Research Management and Foreign Affairs, The Affiliated Hospital of Qingdao University, Qingdao, Shandong China
| | - Zhaisong Gao
- grid.412521.10000 0004 1769 1119Department of Nuclear Medicine, The Affiliated Hospital of Qingdao University, Qingdao, Shandong China
| | - Ju Zhang
- grid.412521.10000 0004 1769 1119Department of Nuclear Medicine, The Affiliated Hospital of Qingdao University, Qingdao, Shandong China
| | - Guangjie Yang
- Department of Nuclear Medicine, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China.
| | - Zhenguang Wang
- Department of Nuclear Medicine, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China.
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Liu HS, Guo Q, Yang H, Zeng M, Xu LQ, Zhang QX, Liu H, Guo JL, Zhang J. SPDL1 Overexpression Is Associated With the 18F-FDG PET/CT Metabolic Parameters, Prognosis, and Progression of Esophageal Cancer. Front Genet 2022; 13:798020. [PMID: 35664322 PMCID: PMC9157543 DOI: 10.3389/fgene.2022.798020] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 04/05/2022] [Indexed: 12/24/2022] Open
Abstract
Esophageal cancer (ESCA) is one of the common malignant tumors. The roles and signaling mechanisms of spindle apparatus coiled-coil protein 1 (SPDL1) in ESCA progression have not been reported previously. Therefore, the expression levels and potential clinical roles of SPDL1 were investigated using data from multiple databases and tissue samples of 53 ESCA patients who underwent 18F-FDG positron emission tomography (PET)/computed tomography (CT) before therapy. The signaling mechanisms of SPDL1 involved in ESCA progression were investigated via bioinformatics analysis. The effects of SPDL1 on the growth and migration of ESCA cells were investigated using CCK-8, Edu, and transwell assays. SPDL1 was upregulated in ESCA tissues. Increased SPDL1 expression was associated with age, grade, drinking history, cancer stage, lymph node metastasis, TP53 mutation, and poor prognosis in patients with ESCA. SPDL1 overexpression was significantly correlated with SUVmax, SUVmean, and TLG of PET/CT. SPDL1 silencing inhibited cell proliferation, migration, and invasion. SPDL1 was significantly enriched in cell cycle, spliceosome, DNA replication, and other processes. The hub genes of a constructed protein–protein interaction network included CDK1, BUB1, CCNB1, BUB1B, CCNA2, CDC20, MAD2L1, AURKB, NDC80, and PLK1, which were related to SPDL1 expression. The findings of this study suggest that SPDL1 may serve as a biomarker of ESCA prognosis.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Jun Zhang
- *Correspondence: Jun Zhang, ; Jia-Long Guo,
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Yamada K, Nohara K, Enomoto N, Wake H, Yagi S, Terayama M, Kato D, Yokoi C, Kojima Y, Nakayama H, Kokudo N. Surgical strategies for treatment of clinical T4 esophageal cancer in Japan. Glob Health Med 2021; 3:371-377. [PMID: 35036618 PMCID: PMC8692096 DOI: 10.35772/ghm.2020.01090] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 04/29/2021] [Accepted: 05/10/2021] [Indexed: 05/14/2023]
Abstract
Definitive chemoradiation (dCRT) is the mainstay treatment for cStage IVa esophageal squamous cell carcinoma (ESCC) with good performance status (PS), according to standard practice guidelines. Salvage surgery may incur operation complications and risk of mortality. According to the esophageal cancer practice guidelines outlined by the Japan Esophageal Society, when a tumor is residual and recurrent, chemotherapy and palliative symptomatic treatment is continued. However, salvage operation has been selected as a therapeutic option for recurrent or residual tumors after dCRT. There is weak evidence for not recommending surgery for cStage IVa ESCC exhibiting residual disease following dCRT. It has been reported that during salvage surgery the only prognostic factor that is thought to be performed is complete resection (R0), but at the same time, salvage esophagectomy increases the incidence of postoperative complications and mortality. The phase II chemoselection study by Yokota T et al. in Japan showed that multidisciplinary treatment initiated by induction therapy, in which docetaxel is added to cisplatin and 5-fluorouracil, resulted in a good prognosis in the short term. In this review, we discuss the surgical strategy and future of unresectable clinical T4 (cT4) ESCC.
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Affiliation(s)
- Kazuhiko Yamada
- Department of Surgery, National Center for Global Health and Medicine, Tokyo, Japan
- Address correspondence to:Kazuhiko Yamada, Department of Surgery, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan. E-mail:
| | - Kyoko Nohara
- Department of Surgery, National Center for Global Health and Medicine, Tokyo, Japan
| | - Naoki Enomoto
- Department of Surgery, National Center for Global Health and Medicine, Tokyo, Japan
| | - Hitomi Wake
- Department of Surgery, National Center for Global Health and Medicine, Tokyo, Japan
| | - Syusuke Yagi
- Department of Surgery, National Center for Global Health and Medicine, Tokyo, Japan
| | - Masayoshi Terayama
- Department of Surgery, National Center for Global Health and Medicine, Tokyo, Japan
| | - Daiki Kato
- Department of Surgery, National Center for Global Health and Medicine, Tokyo, Japan
| | - Chizu Yokoi
- Department of Gastroenterology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yasushi Kojima
- Department of Gastroenterology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Hidetsugu Nakayama
- Department of Radiation Therapy, National Center for Global Health and Medicine, Tokyo, Japan
| | - Norihiro Kokudo
- Department of Surgery, National Center for Global Health and Medicine, Tokyo, Japan
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Gu L, Xie X, Guo Z, Shen W, Qian P, Jiang N, Fan Y. Dynamic contrast-enhanced magnetic resonance imaging: A novel approach to assessing treatment in locally advanced esophageal cancer patients. Niger J Clin Pract 2021; 24:1800-1807. [PMID: 34889788 DOI: 10.4103/njcp.njcp_78_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Aims This study aims to investigate the potential application of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) to predict concurrent chemoradiation (CRT) in locally advanced esophageal carcinoma. Patients and Methods This study involved 33 patients with locally advanced esophageal cancer and treated with CRT. The patients underwent DCE-MRI before CRT (pre) and 3 weeks after starting CRT (mid). The patients were categorized into two groups: complete response (CR) and non-complete response (non-CR) after 3 months of treatment. The quantitative parameters of DCE-MRI (Ktrans, Kep, and Ve), the changes and ratios of parameters (ΔKtrans, ΔKep, ΔVe, rΔKtrans, rΔKep, and rΔVe), and the relative ratio in the tumor area and a normal tube wall (rKtrans, rKep, and rVe) were calculated and compared between two timeframes in two groups, respectively. Moreover, the receiver operating characteristics (ROC) statistical analysis was used to assess the above parameters. Results We divided 33 patients into two groups: 22 in the CR group and 11 in the non-CR group. During the mid-CRT phase in the CR group, both Ktrans and Kep rapidly decreased, while only Kep decreased in the non-CR group. The pre-Ktrans and pre-Kep in the CR group were substantially higher compared to the non-CR group. Moreover, the rKtrans was also apparently observed as higher at pre-CRT in the CR group compared to the non-CR group. The ROC analysis demonstrated that the pre-Ktrans could be the best parameter to evaluate the treatment performance (AUC = 0.74). Conclusion Pre-Ktrans could be a promising parameter to forecast how patients with locally advanced esophageal cancer will respond to CRT.
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Affiliation(s)
- L Gu
- Department of Radiology, The Affiliated Cancer Hospital of Nanjing Medical University and Jiangsu Cancer Hospital and Jiangsu Institute of Cancer Research, Baiziting Road, Nanjing, P. R. China
| | - X Xie
- Department of Radiology, The Affiliated Cancer Hospital of Nanjing Medical University and Jiangsu Cancer Hospital and Jiangsu Institute of Cancer Research, Baiziting Road, Nanjing, P. R. China
| | - Z Guo
- Department of Radiology, The Affiliated Cancer Hospital of Nanjing Medical University and Jiangsu Cancer Hospital and Jiangsu Institute of Cancer Research, Baiziting Road, Nanjing, P. R. China
| | - W Shen
- Department of Radiology, The Affiliated Cancer Hospital of Nanjing Medical University and Jiangsu Cancer Hospital and Jiangsu Institute of Cancer Research, Baiziting Road, Nanjing, P. R. China
| | - P Qian
- Department of Radiation Oncology, The Affiliated Cancer Hospital of Nanjing Medical University and Jiangsu Cancer Hospital and Jiangsu Institute of Cancer Research, Baiziting Road, Nanjing, P. R. China
| | - N Jiang
- Department of Radiation Oncology, The Affiliated Cancer Hospital of Nanjing Medical University and Jiangsu Cancer Hospital and Jiangsu Institute of Cancer Research, Baiziting Road, Nanjing, P. R. China
| | - Y Fan
- Department of Radiation Oncology, The Affiliated Cancer Hospital of Nanjing Medical University and Jiangsu Cancer Hospital and Jiangsu Institute of Cancer Research, Baiziting Road, Nanjing, P. R. China
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Miyawaki Y, Sato H, Fujiwara N, Oya S, Sugita H, Hirano Y, Yamane T, Sakuramoto S, Okamoto K, Yamaguchi S, Koyama I. Association of the primary tumor's SUVmax with survival after surgery for clinical stage IA esophageal cancer: a single-center retrospective study. Int J Clin Oncol 2019; 25:561-569. [PMID: 31867680 DOI: 10.1007/s10147-019-01606-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Accepted: 12/15/2019] [Indexed: 02/08/2023]
Abstract
BACKGROUND Compared to other esophageal cancers, clinical stage IA esophageal cancer generally has a good prognosis, although a subgroup of patients has a poor prognosis. Unfortunately, clinical diagnoses of invasion depth or lymph node metastasis are not always accurate, which make it difficult to identify patients with a high risk of postoperative recurrence using the tumor-node-metastasis staging system. Fluorodeoxyglucose-positron emission tomography may help guide the identification of malignant tumors and the evaluation of their malignant grade based on glucose metabolism. We aimed to evaluate the association between pre-operative fluorodeoxyglucose-positron emission tomography findings and the postoperative prognosis of patients with clinical stage IA esophageal cancer. METHODS This single-center retrospective study evaluated pre-esophagectomy fluorodeoxyglucose-positron emission tomography findings from 38 patients with clinical stage IA esophageal cancer. Receiver operating characteristic curve analysis was performed to evaluate the prognostic significance of the primary tumor having low and high SUVmax values (cut-off: 3.56). RESULTS Overall survival (log-rank p = 0.034) and progression-free survival (log-rank p = 0.008) were significantly different between the groups with low SUVmax values (n = 18) and high SUVmax values (n = 20). Furthermore, the primary tumor's SUVmax value was related to pathological vascular invasion (p = 0.045) and distant metastasis (p = 0.042). CONCLUSION The SUVmax of the primary tumor is a predictor of postoperative survival for clinical stage IA esophageal cancer. Thus, using fluorodeoxyglucose-positron emission tomography to evaluate the primary tumor's glucose metabolism may reflect the tumor's grade and potentially compensate for inaccuracies in tumor-node-metastasis staging.
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Affiliation(s)
- Yutaka Miyawaki
- Department of Gastroenterological Surgery, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka-shi, Saitama, 350-1298, Japan.
| | - Hiroshi Sato
- Department of Gastroenterological Surgery, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka-shi, Saitama, 350-1298, Japan
| | - Naoto Fujiwara
- Department of Gastroenterological Surgery, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka-shi, Saitama, 350-1298, Japan
| | - Shuichiro Oya
- Department of Gastroenterological Surgery, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka-shi, Saitama, 350-1298, Japan
| | - Hirofumi Sugita
- Department of Gastroenterological Surgery, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka-shi, Saitama, 350-1298, Japan
| | - Yasumitsu Hirano
- Department of Gastroenterological Surgery, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka-shi, Saitama, 350-1298, Japan
| | - Tomohiko Yamane
- Department of Nuclear Medicine, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka-shi, Saitama, 350-1298, Japan
| | - Shinichi Sakuramoto
- Department of Gastroenterological Surgery, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka-shi, Saitama, 350-1298, Japan
| | - Kojun Okamoto
- Department of Gastroenterological Surgery, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka-shi, Saitama, 350-1298, Japan
| | - Shigeki Yamaguchi
- Department of Gastroenterological Surgery, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka-shi, Saitama, 350-1298, Japan
| | - Isamu Koyama
- Department of Gastroenterological Surgery, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka-shi, Saitama, 350-1298, Japan
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