Clinical Significance of {sup 18}F-Fluorodeoxyglucose-Positron Emission Tomography-Positive Lymph Nodes to Outcomes of Trimodal Therapy for Esophageal Squamous Cell Carcinoma

Background: The clinical significance of lymph node (LN) status determined by preoperative {sup 18}F-fluorodeoxyglucose-positron emission tomography (FDG-PET) has not been investigated in patients with locally advanced esophageal squamous cell carcinoma (ESCC) treated with neoadjuvant chemoradiother...

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Published in:Annals of surgical oncology 2019-06, Vol.26 (6)
Main Authors: Hamai, Yoichi, Hihara, Jun, Emi, Manabu, Ibuki, Yuta, Murakami, Yuji, Nishibuchi, Ikuno, Nagata, Yasushi, Aoki, Yoshiro, Furukawa, Takaoki, Okada, Morihito
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Language:English
Subjects:
CARCINOMAS
COMBINED THERAPY
ESOPHAGUS
FLUORINE 18
FLUORODEOXYGLUCOSE
FORECASTING
HAZARDS
LYMPH NODES
METASTASES
PATIENTS
POSITRON COMPUTED TOMOGRAPHY
RADIOLOGY AND NUCLEAR MEDICINE
SURGERY
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container_title Annals of surgical oncology
container_volume 26
creator Hamai, Yoichi
Hihara, Jun
Emi, Manabu
Ibuki, Yuta
Murakami, Yuji
Nishibuchi, Ikuno
Nagata, Yasushi
Aoki, Yoshiro
Furukawa, Takaoki
Okada, Morihito
description Background: The clinical significance of lymph node (LN) status determined by preoperative {sup 18}F-fluorodeoxyglucose-positron emission tomography (FDG-PET) has not been investigated in patients with locally advanced esophageal squamous cell carcinoma (ESCC) treated with neoadjuvant chemoradiotherapy (NCRT) followed by surgery (trimodal therapy). Methods: This study reviewed 132 consecutive patients with ESCC who had been preoperatively evaluated using FDG-PET before and after NCRT to analyze associations among LN status according to PET findings, pathologic LN metastasis, and prognosis of ESCC after trimodal therapy. Results: Lymph nodes that were PET-positive both before and after NCRT comprised significant predictive markers of pathologic LN metastasis in station-by-station analyses (sensitivity, specificity, and accuracy respectively 41.7%, 95.0%, and 92.7% before, and 12.0%, 99.4%, and 95.6% after NCRT; both p 
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Methods: This study reviewed 132 consecutive patients with ESCC who had been preoperatively evaluated using FDG-PET before and after NCRT to analyze associations among LN status according to PET findings, pathologic LN metastasis, and prognosis of ESCC after trimodal therapy. Results: Lymph nodes that were PET-positive both before and after NCRT comprised significant predictive markers of pathologic LN metastasis in station-by-station analyses (sensitivity, specificity, and accuracy respectively 41.7%, 95.0%, and 92.7% before, and 12.0%, 99.4%, and 95.6% after NCRT; both p &lt; 0.0001). The numbers of LNs evaluated using PET before and after NCRT were significantly associated with those of pathologic metastatic LNs. Uni- and multivariable analyses selected LN status determined by PET before NCRT as a significant independent predictor of both recurrence-free [LN-negative vs LN-positive: hazard ratio (HR) 1.90; 95% confidence interval (CI) 1.02–3.23; p = 0.045] and overall survival (HR 2.62; 95% CI 1.29–5.30; p = 0.01). Conclusions: The status of LN determined by preoperative FDG-PET is significantly associated with pathologic LN status and the prognosis of ESCC with trimodal therapy. Thus, FDG-PET is a useful diagnostic tool for preoperative prediction of pathologic LN metastasis and survival among patients with ESCC.</description><identifier>ISSN: 1534-4681</identifier><identifier>EISSN: 1534-4681</identifier><identifier>DOI: 10.1245/s10434-019-07158-5</identifier><language>eng</language><publisher>United States</publisher><subject>CARCINOMAS ; COMBINED THERAPY ; ESOPHAGUS ; FLUORINE 18 ; FLUORODEOXYGLUCOSE ; FORECASTING ; HAZARDS ; LYMPH NODES ; METASTASES ; PATIENTS ; POSITRON COMPUTED TOMOGRAPHY ; RADIOLOGY AND NUCLEAR MEDICINE ; SURGERY</subject><ispartof>Annals of surgical oncology, 2019-06, Vol.26 (6)</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27922,27923</link.rule.ids><backlink>$$Uhttps://www.osti.gov/biblio/22927754$$D View this record in Osti.gov$$Hfree_for_read</backlink></links><search><creatorcontrib>Hamai, Yoichi</creatorcontrib><creatorcontrib>Hihara, Jun</creatorcontrib><creatorcontrib>Emi, Manabu</creatorcontrib><creatorcontrib>Ibuki, Yuta</creatorcontrib><creatorcontrib>Murakami, Yuji</creatorcontrib><creatorcontrib>Nishibuchi, Ikuno</creatorcontrib><creatorcontrib>Nagata, Yasushi</creatorcontrib><creatorcontrib>Aoki, Yoshiro</creatorcontrib><creatorcontrib>Furukawa, Takaoki</creatorcontrib><creatorcontrib>Okada, Morihito</creatorcontrib><title>Clinical Significance of {sup 18}F-Fluorodeoxyglucose-Positron Emission Tomography-Positive Lymph Nodes to Outcomes of Trimodal Therapy for Esophageal Squamous Cell Carcinoma</title><title>Annals of surgical oncology</title><description>Background: The clinical significance of lymph node (LN) status determined by preoperative {sup 18}F-fluorodeoxyglucose-positron emission tomography (FDG-PET) has not been investigated in patients with locally advanced esophageal squamous cell carcinoma (ESCC) treated with neoadjuvant chemoradiotherapy (NCRT) followed by surgery (trimodal therapy). Methods: This study reviewed 132 consecutive patients with ESCC who had been preoperatively evaluated using FDG-PET before and after NCRT to analyze associations among LN status according to PET findings, pathologic LN metastasis, and prognosis of ESCC after trimodal therapy. Results: Lymph nodes that were PET-positive both before and after NCRT comprised significant predictive markers of pathologic LN metastasis in station-by-station analyses (sensitivity, specificity, and accuracy respectively 41.7%, 95.0%, and 92.7% before, and 12.0%, 99.4%, and 95.6% after NCRT; both p &lt; 0.0001). The numbers of LNs evaluated using PET before and after NCRT were significantly associated with those of pathologic metastatic LNs. Uni- and multivariable analyses selected LN status determined by PET before NCRT as a significant independent predictor of both recurrence-free [LN-negative vs LN-positive: hazard ratio (HR) 1.90; 95% confidence interval (CI) 1.02–3.23; p = 0.045] and overall survival (HR 2.62; 95% CI 1.29–5.30; p = 0.01). Conclusions: The status of LN determined by preoperative FDG-PET is significantly associated with pathologic LN status and the prognosis of ESCC with trimodal therapy. Thus, FDG-PET is a useful diagnostic tool for preoperative prediction of pathologic LN metastasis and survival among patients with ESCC.</description><subject>CARCINOMAS</subject><subject>COMBINED THERAPY</subject><subject>ESOPHAGUS</subject><subject>FLUORINE 18</subject><subject>FLUORODEOXYGLUCOSE</subject><subject>FORECASTING</subject><subject>HAZARDS</subject><subject>LYMPH NODES</subject><subject>METASTASES</subject><subject>PATIENTS</subject><subject>POSITRON COMPUTED TOMOGRAPHY</subject><subject>RADIOLOGY AND NUCLEAR MEDICINE</subject><subject>SURGERY</subject><issn>1534-4681</issn><issn>1534-4681</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><recordid>eNpNjstKxDAUhosoOI6-gKuA62iubbqUMqPC4Ah2P6Rp0kbantq0YhFfyWe0ogtX5-P8_JcouqTkmjIhbwIlggtMaIpJQqXC8ihaUbm8RKzo8T8-jc5CeCGEJpzIVfSVNb7zRjfo2Veddwt2xiJw6CNMPaLqc4u3zQQDlBbe56qZDASLnyD4cYAObVofgl8ghxaqQff1_Cv6N4t2c9vX6HGxBjQC2k-jgXbhJT0ffAvlUpvXdnHNyMGANgH6Wlf2Z83rpFuYAsps06BMD8Z30Orz6MTpJtiLv7uO8u0mz-7xbn_3kN3uMKRqxJwwxg1TaVIWpWMxVamMC-ko4zS2mheMu9gJ6riwoig45bFWKjVGli6JU8fX0dVvLITRH4LxozW1ga6zZjwwlrIkkYJ_A5DmdLs</recordid><startdate>20190615</startdate><enddate>20190615</enddate><creator>Hamai, Yoichi</creator><creator>Hihara, Jun</creator><creator>Emi, Manabu</creator><creator>Ibuki, Yuta</creator><creator>Murakami, Yuji</creator><creator>Nishibuchi, Ikuno</creator><creator>Nagata, Yasushi</creator><creator>Aoki, Yoshiro</creator><creator>Furukawa, Takaoki</creator><creator>Okada, Morihito</creator><scope>OTOTI</scope></search><sort><creationdate>20190615</creationdate><title>Clinical Significance of {sup 18}F-Fluorodeoxyglucose-Positron Emission Tomography-Positive Lymph Nodes to Outcomes of Trimodal Therapy for Esophageal Squamous Cell Carcinoma</title><author>Hamai, Yoichi ; Hihara, Jun ; Emi, Manabu ; Ibuki, Yuta ; Murakami, Yuji ; Nishibuchi, Ikuno ; Nagata, Yasushi ; Aoki, Yoshiro ; Furukawa, Takaoki ; Okada, Morihito</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-o98t-30223c2897dbdf2618956b5f12316ea3b23f6f41f34e4bb3136a889cc5df769f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>CARCINOMAS</topic><topic>COMBINED THERAPY</topic><topic>ESOPHAGUS</topic><topic>FLUORINE 18</topic><topic>FLUORODEOXYGLUCOSE</topic><topic>FORECASTING</topic><topic>HAZARDS</topic><topic>LYMPH NODES</topic><topic>METASTASES</topic><topic>PATIENTS</topic><topic>POSITRON COMPUTED TOMOGRAPHY</topic><topic>RADIOLOGY AND NUCLEAR MEDICINE</topic><topic>SURGERY</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hamai, Yoichi</creatorcontrib><creatorcontrib>Hihara, Jun</creatorcontrib><creatorcontrib>Emi, Manabu</creatorcontrib><creatorcontrib>Ibuki, Yuta</creatorcontrib><creatorcontrib>Murakami, Yuji</creatorcontrib><creatorcontrib>Nishibuchi, Ikuno</creatorcontrib><creatorcontrib>Nagata, Yasushi</creatorcontrib><creatorcontrib>Aoki, Yoshiro</creatorcontrib><creatorcontrib>Furukawa, Takaoki</creatorcontrib><creatorcontrib>Okada, Morihito</creatorcontrib><collection>OSTI.GOV</collection><jtitle>Annals of surgical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hamai, Yoichi</au><au>Hihara, Jun</au><au>Emi, Manabu</au><au>Ibuki, Yuta</au><au>Murakami, Yuji</au><au>Nishibuchi, Ikuno</au><au>Nagata, Yasushi</au><au>Aoki, Yoshiro</au><au>Furukawa, Takaoki</au><au>Okada, Morihito</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinical Significance of {sup 18}F-Fluorodeoxyglucose-Positron Emission Tomography-Positive Lymph Nodes to Outcomes of Trimodal Therapy for Esophageal Squamous Cell Carcinoma</atitle><jtitle>Annals of surgical oncology</jtitle><date>2019-06-15</date><risdate>2019</risdate><volume>26</volume><issue>6</issue><issn>1534-4681</issn><eissn>1534-4681</eissn><abstract>Background: The clinical significance of lymph node (LN) status determined by preoperative {sup 18}F-fluorodeoxyglucose-positron emission tomography (FDG-PET) has not been investigated in patients with locally advanced esophageal squamous cell carcinoma (ESCC) treated with neoadjuvant chemoradiotherapy (NCRT) followed by surgery (trimodal therapy). Methods: This study reviewed 132 consecutive patients with ESCC who had been preoperatively evaluated using FDG-PET before and after NCRT to analyze associations among LN status according to PET findings, pathologic LN metastasis, and prognosis of ESCC after trimodal therapy. Results: Lymph nodes that were PET-positive both before and after NCRT comprised significant predictive markers of pathologic LN metastasis in station-by-station analyses (sensitivity, specificity, and accuracy respectively 41.7%, 95.0%, and 92.7% before, and 12.0%, 99.4%, and 95.6% after NCRT; both p &lt; 0.0001). The numbers of LNs evaluated using PET before and after NCRT were significantly associated with those of pathologic metastatic LNs. Uni- and multivariable analyses selected LN status determined by PET before NCRT as a significant independent predictor of both recurrence-free [LN-negative vs LN-positive: hazard ratio (HR) 1.90; 95% confidence interval (CI) 1.02–3.23; p = 0.045] and overall survival (HR 2.62; 95% CI 1.29–5.30; p = 0.01). Conclusions: The status of LN determined by preoperative FDG-PET is significantly associated with pathologic LN status and the prognosis of ESCC with trimodal therapy. Thus, FDG-PET is a useful diagnostic tool for preoperative prediction of pathologic LN metastasis and survival among patients with ESCC.</abstract><cop>United States</cop><doi>10.1245/s10434-019-07158-5</doi></addata></record>
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subjects CARCINOMAS
COMBINED THERAPY
ESOPHAGUS
FLUORINE 18
FLUORODEOXYGLUCOSE
FORECASTING
HAZARDS
LYMPH NODES
METASTASES
PATIENTS
POSITRON COMPUTED TOMOGRAPHY
RADIOLOGY AND NUCLEAR MEDICINE
SURGERY
title Clinical Significance of {sup 18}F-Fluorodeoxyglucose-Positron Emission Tomography-Positive Lymph Nodes to Outcomes of Trimodal Therapy for Esophageal Squamous Cell Carcinoma
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