Impact of number of [(18)F]fluorodeoxyglucose-PET-positive lymph nodes on survival of patients receiving neoadjuvant chemotherapy and surgery for oesophageal cancer.
BACKGROUND
[(18) F]fluorodeoxyglucose (FDG)-PET has been used to evaluate the response of primary tumours to neoadjuvant therapy for oesophageal cancer. The clinical significance of the number of PET-positive nodes before and after therapy has not been investigated previously.


METHODS
[(18) F]FDG-PET was performed before and 2-3 weeks after completion of neoadjuvant chemotherapy to identify the number of PET-positive nodes, and these numbers were assessed in relation to metabolic changes in the primary tumour.


RESULTS
Of 302 patients in total, 90 had no PET-positive nodes, 83 had one, 59 had two and 70 patients had three or more positive nodes before therapy. After treatment, the numbers were: none in 207 patients, one in 59, two in 20 and three or more in 16 patients. The number of PET-positive nodes after treatment was influenced by both the number of PET-positive nodes before therapy and the response to preoperative therapy, and correlated with the number of metastatic lymph nodes. Overall survival was longer in patients who had no PET-positive nodes after treatment than in those who had one or more. Multivariable analysis identified the numbers of PET-positive nodes before and after chemotherapy as independent prognostic factors, together with clinical response, tumour depth and lymph node involvement.


CONCLUSIONS
The number of PET-positive nodes after treatment correlated with survival in patients with oesophageal cancer who underwent neoadjuvant chemotherapy.
Departments of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan.|Department of Surgery, Osaka Medical Centre for Cancer and Cardiovascular Diseases, Osaka, Japan.
H
H
Miyata
Departments of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan.
M
M
Yamasaki
Departments of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan.
T
T
Makino
Departments of Nuclear Medicine and Tracer Kinetics, Graduate School of Medicine, Osaka University, Osaka, Japan.
M
M
Tatsumi
Departments of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan.
Y
Y
Miyazaki
Departments of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan.
T
T
Takahashi
Departments of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan.
Y
Y
Kurokawa
Departments of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan.
S
S
Takiguchi
Departments of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan.
M
M
Mori
Departments of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan.
Y
Y
Doki
D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D004938:Esophageal Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery; D016629:Esophagectomy; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18