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Risk stratification of oesophageal squamous cell carcinoma using change in total lesion glycolysis and number of PET-positive lymph nodes

BACKGROUND: The efficacy of neoadjuvant chemotherapy (NACT) correlates with patient survival in oesophageal squamous cell carcinoma (OSCC), but optimal evaluation of the treatment response based on PET-CT parameters has not been established. METHODS: We analysed 226 OSCC patients who underwent PET-C...

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Autores principales: Nose, Yohei, Makino, Tomoki, Tatsumi, Mitsuaki, Tanaka, Koji, Yamashita, Kotaro, Noma, Toshiki, Saito, Takuro, Yamamoto, Kazuyoshi, Takahashi, Tsuyoshi, Kurokawa, Yukinori, Nakajima, Kiyokazu, Eguchi, Hidetoshi, Doki, Yuichiro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10147681/
https://www.ncbi.nlm.nih.gov/pubmed/36841907
http://dx.doi.org/10.1038/s41416-023-02151-y
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author Nose, Yohei
Makino, Tomoki
Tatsumi, Mitsuaki
Tanaka, Koji
Yamashita, Kotaro
Noma, Toshiki
Saito, Takuro
Yamamoto, Kazuyoshi
Takahashi, Tsuyoshi
Kurokawa, Yukinori
Nakajima, Kiyokazu
Eguchi, Hidetoshi
Doki, Yuichiro
author_facet Nose, Yohei
Makino, Tomoki
Tatsumi, Mitsuaki
Tanaka, Koji
Yamashita, Kotaro
Noma, Toshiki
Saito, Takuro
Yamamoto, Kazuyoshi
Takahashi, Tsuyoshi
Kurokawa, Yukinori
Nakajima, Kiyokazu
Eguchi, Hidetoshi
Doki, Yuichiro
author_sort Nose, Yohei
collection PubMed
description BACKGROUND: The efficacy of neoadjuvant chemotherapy (NACT) correlates with patient survival in oesophageal squamous cell carcinoma (OSCC), but optimal evaluation of the treatment response based on PET-CT parameters has not been established. METHODS: We analysed 226 OSCC patients who underwent PET-CT before and after NACT followed by surgery. We assessed SUVmax, metabolic tumour volume (MTV), and total lesion glycolysis (TLG) for the primary tumour and the number of PET-positive lymph nodes before and after NACT to predict patient survival. RESULTS: In a stepwise analysis, we defined 60%, 80%, and 80% as the optimal cut-off values for SUVmax, MTV, and TLG reduction, respectively, to distinguish responders and non-responders to NACT. In the ROC analysis, the TLG reduction rate was the best predictor of recurrence among PET-CT parameters. The TLG responders achieved significantly more favourable prognoses than non-responders (2-year progression-free survival [PFS] rate: 64.1% vs. 38.5%; P = 0.0001). TLG reduction rate (HR 2.58; 95% CI 1.16–5.73) and the number of PET-positive lymph nodes after NACT (HR 1.79; 95% CI 1.04–3.08) were significant independent prognostic factors. CONCLUSIONS: TLG reduction is the best predictor of prognosis. Preoperative PET-CT evaluation of both the primary tumour and lymph nodes could accurately stratify risk in OSCC patients.
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spelling pubmed-101476812023-04-30 Risk stratification of oesophageal squamous cell carcinoma using change in total lesion glycolysis and number of PET-positive lymph nodes Nose, Yohei Makino, Tomoki Tatsumi, Mitsuaki Tanaka, Koji Yamashita, Kotaro Noma, Toshiki Saito, Takuro Yamamoto, Kazuyoshi Takahashi, Tsuyoshi Kurokawa, Yukinori Nakajima, Kiyokazu Eguchi, Hidetoshi Doki, Yuichiro Br J Cancer Article BACKGROUND: The efficacy of neoadjuvant chemotherapy (NACT) correlates with patient survival in oesophageal squamous cell carcinoma (OSCC), but optimal evaluation of the treatment response based on PET-CT parameters has not been established. METHODS: We analysed 226 OSCC patients who underwent PET-CT before and after NACT followed by surgery. We assessed SUVmax, metabolic tumour volume (MTV), and total lesion glycolysis (TLG) for the primary tumour and the number of PET-positive lymph nodes before and after NACT to predict patient survival. RESULTS: In a stepwise analysis, we defined 60%, 80%, and 80% as the optimal cut-off values for SUVmax, MTV, and TLG reduction, respectively, to distinguish responders and non-responders to NACT. In the ROC analysis, the TLG reduction rate was the best predictor of recurrence among PET-CT parameters. The TLG responders achieved significantly more favourable prognoses than non-responders (2-year progression-free survival [PFS] rate: 64.1% vs. 38.5%; P = 0.0001). TLG reduction rate (HR 2.58; 95% CI 1.16–5.73) and the number of PET-positive lymph nodes after NACT (HR 1.79; 95% CI 1.04–3.08) were significant independent prognostic factors. CONCLUSIONS: TLG reduction is the best predictor of prognosis. Preoperative PET-CT evaluation of both the primary tumour and lymph nodes could accurately stratify risk in OSCC patients. Nature Publishing Group UK 2023-02-25 2023-05-11 /pmc/articles/PMC10147681/ /pubmed/36841907 http://dx.doi.org/10.1038/s41416-023-02151-y Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Article
Nose, Yohei
Makino, Tomoki
Tatsumi, Mitsuaki
Tanaka, Koji
Yamashita, Kotaro
Noma, Toshiki
Saito, Takuro
Yamamoto, Kazuyoshi
Takahashi, Tsuyoshi
Kurokawa, Yukinori
Nakajima, Kiyokazu
Eguchi, Hidetoshi
Doki, Yuichiro
Risk stratification of oesophageal squamous cell carcinoma using change in total lesion glycolysis and number of PET-positive lymph nodes
title Risk stratification of oesophageal squamous cell carcinoma using change in total lesion glycolysis and number of PET-positive lymph nodes
title_full Risk stratification of oesophageal squamous cell carcinoma using change in total lesion glycolysis and number of PET-positive lymph nodes
title_fullStr Risk stratification of oesophageal squamous cell carcinoma using change in total lesion glycolysis and number of PET-positive lymph nodes
title_full_unstemmed Risk stratification of oesophageal squamous cell carcinoma using change in total lesion glycolysis and number of PET-positive lymph nodes
title_short Risk stratification of oesophageal squamous cell carcinoma using change in total lesion glycolysis and number of PET-positive lymph nodes
title_sort risk stratification of oesophageal squamous cell carcinoma using change in total lesion glycolysis and number of pet-positive lymph nodes
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10147681/
https://www.ncbi.nlm.nih.gov/pubmed/36841907
http://dx.doi.org/10.1038/s41416-023-02151-y
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