Significant clinical impact and prognostic stratification provided by FDG-PET in the staging of oesophageal cancer.
OBJECTIVE
To evaluate the clinical impact of FDG-PET in staging oesophageal cancer and whether this information improves prognostic stratification.


METHODS
Impact was based on comparison of a prospectively recorded pre-PET plan with post-PET treatment in 68 consecutive patients undergoing primary staging. Survival was analysed using the Kaplan-Meier product limit method and the Cox proportional hazards regression model.


RESULTS
FDG-PET findings impacted on the management of 27/68 patients (40%): in 12 therapy was changed from curative to palliative and in three from palliative to curative, while in 12 other patients there was a change in the treatment modality or delivery but not in the treatment intent. The median survival was 21 months, with post-PET stage and treatment intent both strongly associated with survival (p<0.001). Conventional stage was not able to clearly stratify this population.


CONCLUSIONS
The use of FDG-PET for primary staging of oesophageal cancer changed the clinical management of more than one-third of patients and provided superior prognostic stratification compared with conventional investigations.
Division of Surgical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
Cuong P
CP
Duong
Helen
H
Demitriou
Leann
L
Weih
Anne
A
Thompson
David
D
Williams
Robert J S
RJ
Thomas
Rodney J
RJ
Hicks
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia / Q000453:epidemiology; D004938:Esophageal Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000628:therapy*; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods* / Q000706:statistics & numerical data; D049268:Positron-Emission Tomography / Q000379:methods / Q000706:statistics & numerical data*; D015995:Prevalence; D011379:Prognosis; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016019:Survival Analysis; D015996:Survival Rate; D016896:Treatment Outcome
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18