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Dong X, Sun X, Zhao X, Zhu W, Sun L, Huang Y, Li W, Wan H, Xing L, Yu J. The impact of intratumoral metabolic heterogeneity on postoperative recurrence and survival in resectable esophageal squamous cell carcinoma. Oncotarget 2017; 8:14969-14977. [PMID: 28122340 PMCID: PMC5362458 DOI: 10.18632/oncotarget.14743] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Accepted: 01/10/2017] [Indexed: 01/18/2023] Open
Abstract
OBJECTIVE To evaluate the impact of intratumoral metabolic heterogeneity measured by 18F-FDG PET imaging on postoperative recurrence and survival for patients with esophageal squamous cell carcinoma (ESCC). RESULTS AUC-CSH, metabolic tumor volume and pN-stage were significant prognostic factors for RFS. Additionally, tumor recurrence of the low AUC-CSH group (≤ 0.478) was 3 times higher than high group (P = 0.015). The median OS of patients with advanced AJCC stage or low AUC-CSH was also significantly shorter than that of patients with stage I & II or high AUC-CSH (P = 0.021, 0.009). Multivariate analysis identified the AUC-CSH to be the only significant risk factor for postoperative recurrence and overall survival in whole-group and stage III patients. MATERIALS AND METHODS 116 ESCC patients who underwent staging 18F-FDG PET-CT scan and surgical resection were reviewed. The metabolic parameters were assessed as follows: maximum standardized uptake value (SUVmax), metabolic tumor volume, and the area under the curve of the cumulative SUV-volume histogram (AUC-CSH), which is known to reflect the intratumoral metabolic heterogeneity. Regression analyses were used to identify clinicopathological and imaging variables associated with relapse-free survival (RFS) and overall survival (OS). CONCLUSIONS Intratumoral metabolic heterogeneity characterized by AUC-CSH can predict postoperative recurrence and survival in patients with resectable ESCC.
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Affiliation(s)
- Xinzhe Dong
- Department of Radiation Oncology, Shandong Cancer Hospital, Shandong University, Jinan, Shandong, China
- Key Laboratory of Radiation Oncology of Shandong Province, Shandong Academy of Medical Sciences, Jinan, Shandong, China
| | - Xiaorong Sun
- Department of Radiology, Shandong Cancer Hospital and Institute, Jinan, Shandong, China
| | - Xianguang Zhao
- Department of Radiation Oncology, Shandong Cancer Hospital, Shandong University, Jinan, Shandong, China
| | - Wanqi Zhu
- Department of Radiation Oncology, Shandong Cancer Hospital, Shandong University, Jinan, Shandong, China
| | - Lu Sun
- Jinan University, Jinan, Shandong, China
| | - Yong Huang
- Department of Radiology, Shandong Cancer Hospital and Institute, Jinan, Shandong, China
| | - Wenwu Li
- Department of Radiology, Shandong Cancer Hospital and Institute, Jinan, Shandong, China
| | - Honglin Wan
- College of Physics and Electronic Science, Shandong Normal University, Jinan, Shandong, China
| | - Ligang Xing
- Department of Radiation Oncology, Shandong Cancer Hospital, Shandong University, Jinan, Shandong, China
- Key Laboratory of Radiation Oncology of Shandong Province, Shandong Academy of Medical Sciences, Jinan, Shandong, China
| | - Jinming Yu
- Department of Radiation Oncology, Shandong Cancer Hospital, Shandong University, Jinan, Shandong, China
- Key Laboratory of Radiation Oncology of Shandong Province, Shandong Academy of Medical Sciences, Jinan, Shandong, China
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