Original articleGeneral thoracicMaximum Standardized Uptake Values on Positron Emission Tomography of Esophageal Cancer Predicts Stage, Tumor Biology, and Survival
Section snippets
Patients
This is a retrospective analysis of an electronic prospective database. Patients who presented to one surgeon between May 2000 and June 2005 with biopsy-proven, apparently resectable (no evidence of T4 or M1 disease) esophageal cancer were eligible. Patients with high-grade dysplasia were also candidates for this study. All patients underwent clinical staging with a CT scan, endoscopic ultrasound fine-needle aspiration (EUS-FNA), and FDG-PET scanning. Patients were excluded if they were less
Patient Characteristics
Of the total of 92 patients, 3 operative deaths were excluded from further analysis, thus leaving 89 patients (53 men) with a median age of 64 years (range, 29 to 81). Patient characteristics, pathology, the median maxSUV, and outcomes are summarized in Table 1. Complications included atrial fibrillation in 8 patients, pneumonia in 7 (caused by aspiration in 4), chylothorax in 2, and liver failure, an ischemic cecum, acute renal failure, superior mesenteric embolus, and deep venous thrombosis
Comment
The treatment of esophageal cancer, like most solid organ tumors, is dependent on the stage. The current TNM staging system for esophageal cancer is based only on anatomic as opposed to biological factors. However, there is increasing evidence that biological factors influence prognosis just as much, if not more than, anatomical factors [10, 11, 12]; FDG-PET may be a noninvasive modality that aids in the detection of some of these genetic, oncologic, and biological factors. Most importantly, it
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