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The Impact of 18F-Fluorodeoxyglucose Positron Emission Tomography Positive Lymph Nodes on Postoperative Recurrence and Survival in Resectable Thoracic Esophageal Squamous Cell Carcinoma

  • Thoracic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Induction therapy is not always beneficial for all patients. Therefore, it is important to identify the patients with a high rate of recurrence. The occurrence of lymph node metastases (LNMs) strongly influences the postoperative survival in patients with esophageal cancer. We investigated the usefulness of an LN evaluation by initial 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) in prediction of postoperative recurrence for patients with resectable esophageal squamous cell carcinoma (ESCC).

Methods

A total of 76 ESCC patients who did not undergo induction therapy, but who did receive a curative resection were divided into PET-node (PET-N) positive (n = 26) and negative (n = 50) groups according to the presence or absence of FDG uptake in LNs. The PET-N status was compared with the size and the number of LNMs, as well as with the survival and failure patterns.

Results

PET positive LNs involved a significantly larger size of metastatic nests than PET negative LNs (P = 0.002). The PET-N negative group showed a higher proportion of patients with 2 or fewer LNMs (92.0%), a higher 5-year relapse-free survival (75.1%) and a higher overall survival (70.0%), and a lower postoperative recurrence (24.0%) than the 15.4, 29.6, 30.3, and 69.2% values in the PET-N positive group, respectively, (P < 0.005). Multivariate analyses identified the PET-N status to be the most significant preoperative risk factor for postoperative recurrence (P = 0.031).

Conclusion

The preoperative PET-N status in patients with resectable ESCC was significantly associated with the size and the number of LNMs and was therefore found to reliably identify the high-risk population for postoperative recurrence.

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Acknowledgment

The authors thank Professor Yasutaka Chiba from the department of Clinical Research Center, Kinki University School of Medicine for dedicated advices regarding statistical analysis and Professor Makoto Hosono from the PET department of Kinki University School of Medicine for comments in the procedure of PET examination.

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Authors and Affiliations

  1. Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan

    Takushi Yasuda, Ichiro Higuchi, Masahiko Yano, Hiroshi Miyata, Makoto Yamasaki, Shuji Takiguchi, Yoshiyuki Fujiwara & Yuichiro Doki

  2. Department of Tracer Kinetics and Nuclear Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan

    Jun Hatazawa

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  1. Takushi Yasuda
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Correspondence to Takushi Yasuda.

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Yasuda, T., Higuchi, I., Yano, M. et al. The Impact of 18F-Fluorodeoxyglucose Positron Emission Tomography Positive Lymph Nodes on Postoperative Recurrence and Survival in Resectable Thoracic Esophageal Squamous Cell Carcinoma. Ann Surg Oncol 19, 652–660 (2012). https://doi.org/10.1245/s10434-011-1928-4

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