title: [Prognostic value of the metabolically active tumour volume].
abstract: OBJECTIVE
  The purpose of this study was to assess the prognostic value of different parameters on pretreatment fluorodeoxyglucose [((18)F)-FDG] positron emission tomography-computed tomography (PET-CT) in patients with localized oesophageal cancer.
  
  
  METHODS
  We retrospectively reviewed 83 cases of localised oesophageal cancer treated in our institution. Patients were treated with curative intent and have received chemoradiotherapy alone or followed by surgery. Different prognostic parameters were correlated to survival: cancer-related factors, patient-related factors and parameters derived from PET-CT (maximum standardized uptake value [SUV max], metabolically active tumor volume either measured with an automatic segmentation software ["fuzzy locally adaptive bayesian": MATVFLAB] or with an adaptive threshold method [MATVseuil] and total lesion glycolysis [TLGFLAB and TLGseuil]).
  
  
  RESULTS
  The median follow-up was 21.8 months (range: 0.16-104). The median overall survival was 22 months (95% confidence interval [95%CI]: 15.2-28.9). There were 67 deaths: 49 associated with cancer and 18 from intercurrent causes. None of the tested factors was significant on overall survival. In univariate analysis, the following three factors affected the specific survival: MATVFLAB (P=0.025), TLGFLAB (P=0.04) and TLGseuil (P=0.04). In multivariate analysis, only MATVFLAB had a significant impact on specific survival (P=0.049): MATVFLAB<18 cm(3): 31.2 months (95%CI: 21.7-not reached) and MATVFLAB>18 cm(3): 20 months (95%CI: 11.1-228.9).
  
  
  CONCLUSIONS
  The metabolically active tumour volume measured with the automatic segmentation software FLAB on baseline PET-CT was a significant prognostic factor, which should be tested on a larger cohort.
authors.affiliation: Service de radiothérapie, institut de cancérologie de l'Ouest Paul-Papin, 15, rue Boquel, CS 10059, 49055 Angers cedex 02, France. Electronic address: amaury.paumier@ico.unicancer.fr.
authors.forename: A
authors.initials: A
authors.lastname: Paumier
authors.affiliation: Service de radiothérapie, institut de cancérologie de l'Ouest Paul-Papin, 15, rue Boquel, CS 10059, 49055 Angers cedex 02, France.
authors.forename: A
authors.initials: A
authors.lastname: Marquis
authors.affiliation: Service de radiothérapie, institut de cancérologie de l'Ouest Paul-Papin, 15, rue Boquel, CS 10059, 49055 Angers cedex 02, France.
authors.forename: P
authors.initials: P
authors.lastname: Trémolières
authors.affiliation: Service de médecine nucléaire, institut de cancérologie de l'Ouest Paul-Papin, 15, rue Boquel, CS 10059, 49055 Angers cedex 02, France.
authors.forename: M
authors.initials: M
authors.lastname: Lacombe
authors.affiliation: Service d'oncologie médicale, institut de cancérologie de l'Ouest Paul-Papin, 15, rue Boquel, CS 10059, 49055 Angers cedex 02, France.
authors.forename: O
authors.initials: O
authors.lastname: Capitain
authors.affiliation: Département de recherche clinique, institut de cancérologie de l'Ouest Paul-Papin, 15, rue Boquel, CS 10059, 49055 Angers cedex 02, France.
authors.forename: A-L
authors.initials: AL
authors.lastname: Septans
authors.affiliation: Service de radiothérapie, institut de cancérologie de l'Ouest Paul-Papin, 15, rue Boquel, CS 10059, 49055 Angers cedex 02, France.
authors.forename: G
authors.initials: G
authors.lastname: Peyraga
authors.affiliation: Service de radiothérapie, institut de cancérologie de l'Ouest Paul-Papin, 15, rue Boquel, CS 10059, 49055 Angers cedex 02, France.
authors.forename: P
authors.initials: P
authors.lastname: Gustin
authors.affiliation: Service de chirurgie viscérale, CHU d'Angers, 4, rue Larrey, 49100 Angers, France.
authors.forename: A
authors.initials: A
authors.lastname: Vénara
authors.affiliation: Service d'hépatogastroentérologie, CHU d'Angers, 4, rue Larrey, 49100 Angers, France.
authors.forename: É
authors.initials: É
authors.lastname: Ménager
authors.affiliation: Inserm, UMR 1101, Laboratoire de traitement de l'information médicale (Latim), 2, avenue Maréchal-Foch, 29200 Brest, France; UMR 1101, CHRU Morvan, 2, avenue Maréchal-Foch, 29200 Brest, France.
authors.forename: D
authors.initials: D
authors.lastname: Visvikis
authors.affiliation: Service de médecine nucléaire, CHU d'Angers, 4, rue Larrey, 49100 Angers, France.
authors.forename: O
authors.initials: O
authors.lastname: Couturier
authors.affiliation: Service de radiothérapie, institut de cancérologie de l'Ouest René-Gauducheau, boulevard Jacques-Monod, 44805 Saint-Herblain, France.
authors.forename: E
authors.initials: E
authors.lastname: Rio
authors.affiliation: Inserm, UMR 1101, Laboratoire de traitement de l'information médicale (Latim), 2, avenue Maréchal-Foch, 29200 Brest, France; UMR 1101, CHRU Morvan, 2, avenue Maréchal-Foch, 29200 Brest, France.
authors.forename: M
authors.initials: M
authors.lastname: Hatt
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging* / Q000401:mortality / Q000628:therapy; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging* / Q000401:mortality / Q000628:therapy; D059248:Chemoradiotherapy; D004938:Esophageal Neoplasms / Q000000981:diagnostic imaging* / Q000401:mortality / Q000628:therapy; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D015999:Multivariate Analysis; D049268:Positron-Emission Tomography; D011379:Prognosis; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D047368:Tumor Burden
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: Automatic segmentation; Cancer de l’œsophage; FLAB; Facteur pronostique; Metabolically active tumour volume; Oesophageal cancer; Positron emission tomography; Prognostic factor; Quantification; Radiotherapy; Radiothérapie; Segmentation automatique; Tomographie par émission de positons; Volume tumoral métabolique