Department of Oncology, Jen-Ai Hospital-Ta Li, Taichung, Taiwan, ROC.
Anticancer Res. 2012 Sep;32(9):4163-8.
To investigate the prognostic role of the pretreatment metabolic tumor volume (MTV) as determined by Positron emission tomography--computed tomography (PET-CT) in patients with esophageal cancer undergoing curative surgery.
We retrospectively reviewed the data of 26 patients with squamous cell carcinoma of the esophagus, who underwent 18F-Fluorodeoxyglucose PET-CT before surgery. MTVs were defined as the volumes with FDG uptake above a standardized uptake value (SUV) of 2.5 (MTV2.5), or a fixed threshold of 20% (MTV20%) of the maximum intratumoral activity. Overall survival (OS) and disease-free survival (DFS) were examined by the Kaplan-Meier method and the log-rank test.
In a median follow-up of 15 months, 13 patients had died. The mean MTV2.5 was 18.9 ± 15.4 ml (median, 16.0), whereas the mean MTV20% was 21.7 ± 15.0 ml (median, 19.1). Patients who had tumors of an MTV2.5 >16.0 ml had an inferior one-year OS compared with patients with a lower MTV2.5 (70% vs. 84%, p=0.018). Similarly, patients with an MTV20% >19.1 ml had poorer outcomes compared with patients who had small tumors, with one-year OS of 69% and 85%, respectively (p=0.016). No statistical significance was found in DFS for both MTV approaches. The SUVp-max had no impact on the OS and the DFS when using a median value of 8.3.
Pretreatment MTV is a novel marker for OS of patients with esophageal cancer treated with curative surgery. For those with higher MTVs, more aggressive adjuvant treatments should be considered.
探讨正电子发射断层扫描-计算机断层扫描（PET-CT）测定的治疗前代谢肿瘤体积（MTV）在接受根治性手术的食管癌患者中的预后作用。
我们回顾性分析了 26 例接受 18F-氟脱氧葡萄糖 PET-CT 检查的食管鳞状细胞癌患者的数据。MTV 定义为 FDG 摄取量高于标准摄取值（SUV）2.5（MTV2.5）或最大肿瘤内活性的 20%（MTV20%）的体积。采用 Kaplan-Meier 法和对数秩检验检查总生存率（OS）和无病生存率（DFS）。
在 15 个月的中位随访中，13 例患者死亡。MTV2.5 的平均值为 18.9 ± 15.4 ml（中位数为 16.0），而 MTV20% 的平均值为 21.7 ± 15.0 ml（中位数为 19.1）。MTV2.5>16.0 ml 的患者 1 年 OS 低于 MTV2.5 较低的患者（70%比 84%，p=0.018）。同样，MTV20%>19.1 ml 的患者与肿瘤较小的患者相比，预后较差，1 年 OS 分别为 69%和 85%（p=0.016）。两种 MTV 方法的 DFS 均无统计学意义。当 SUVp-max 使用 8.3 的中位数时，对 OS 和 DFS 没有影响。
治疗前 MTV 是接受根治性手术治疗的食管癌患者 OS 的新型标志物。对于 MTV 较高的患者，应考虑更积极的辅助治疗。
