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手术切除的食管鳞状细胞癌:患者生存和临床病理预后因素。

Surgically Resected Esophageal Squamous Cell Carcinoma: Patient Survival and Clinicopathological Prognostic Factors.

机构信息

Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, South Korea.

Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, South Korea.

出版信息

Sci Rep. 2020 Mar 19;10(1):5077. doi: 10.1038/s41598-020-62028-5.

Abstract

We aimed to report patients' survival after surgical resection of eSCC and to ascertain the clinical, imaging, and pathological factors related to patient prognosis. This retrospective study included 435 patients with eSCC of <stage T2 (median follow-up period, 49.3 months). A total of 103 (23.7%) patients died, and 89 (20.5%) experienced recurrence during follow-up. The maximum standardized uptake value (SUV) on positron emission tomography (PET)/computed tomography (CT) of the primary tumor was significantly correlated with tumor length, nodal metastasis, and pathologic T stage in a positive linear fashion. In the multivariate analysis, higher SUV on PET/CT was a negative prognostic factor for both disease-free survival (DFS) and overall survival (OS). Contrarily, the presence of nodal metastasis was a prognostic factor only for DFS, and pathologic T stage only for OS. By applying SUVmax cut-off, both DFS and OS were significantly different among three groups when divided by cut-off values (A: SUVmax ≤ 3.05, B: SUVmax 3.06 - 5.64, C: SUVmax ≥ 5.65). In patients with a surgically resectable eSCC, measuring the SUV of the primary tumor during PET/CT can help predict patient survival. Additionally, PET/CT renders triage criterion for endoscopic submucosal dissection (ESD; T1a cancer and SUVmax, ≤3.05).

摘要

我们旨在报告接受手术切除的食管鳞癌患者的生存情况,并确定与患者预后相关的临床、影像学和病理学因素。这项回顾性研究纳入了 435 例 T2 期以下(中位随访时间为 49.3 个月)的食管鳞癌患者。共有 103 例(23.7%)患者死亡,89 例(20.5%)患者在随访期间复发。原发肿瘤的正电子发射断层扫描(PET)/计算机断层扫描(CT)最大标准化摄取值(SUV)与肿瘤长度、淋巴结转移和病理 T 分期呈正线性相关。多因素分析显示,PET/CT 上较高的 SUV 是疾病无进展生存(DFS)和总生存(OS)的负预后因素。相反,淋巴结转移仅与 DFS 相关,而病理 T 分期仅与 OS 相关。根据 SUVmax 截断值,当分为三组时,DFS 和 OS 存在显著差异(A:SUVmax≤3.05,B:SUVmax 3.06-5.64,C:SUVmax≥5.65)。在可手术切除的食管鳞癌患者中,PET/CT 测量原发肿瘤的 SUV 有助于预测患者的生存情况。此外,PET/CT 还为内镜黏膜下剥离术(ESD)提供了分类标准(T1a 癌症和 SUVmax≤3.05)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/28bc/7081270/4c51e6f71a6d/41598_2020_62028_Fig1_HTML.jpg

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