Oncotarget

Research Papers:

The impact of intratumoral metabolic heterogeneity on postoperative recurrence and survival in resectable esophageal squamous cell carcinoma

Xinzhe Dong, Xiaorong Sun, Xianguang Zhao, Wanqi Zhu, Lu Sun, Yong Huang, Wenwu Li, Honglin Wan, Ligang Xing _ and Jinming Yu

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Oncotarget. 2017; 8:14969-14977. https://doi.org/10.18632/oncotarget.14743

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Abstract

Xinzhe Dong1,2, Xiaorong Sun3, Xianguang Zhao1, Wanqi Zhu1, Lu Sun4, Yong Huang3, Wenwu Li3, Honglin Wan5, Ligang Xing1,2, Jinming Yu1,2

1Department of Radiation Oncology, Shandong Cancer Hospital, Shandong University, Jinan, Shandong, China

2Key Laboratory of Radiation Oncology of Shandong Province, Shandong Academy of Medical Sciences, Jinan, Shandong, China

3Department of Radiology, Shandong Cancer Hospital and Institute, Jinan, Shandong, China

4Jinan University, Jinan, Shandong, China

5College of Physics and Electronic Science, Shandong Normal University, Jinan, Shandong, China

Correspondence to:

Ligang Xing, email: [email protected]

Keywords: positron emission tomography, FDG, esophageal carcinoma, intratumoral heterogeneity, prognosis

Received: July 18, 2016     Accepted: January 10, 2017     Published: January 19, 2017

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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