Clinical Significance of 18F-fluorodeoxyglucose Positron Emission Tomography in Superficial Esophageal Squamous Cell Carcinoma

• Published in: Annals of surgical oncology Vol. 20; no. 5; pp. 1646 - 1652
• Main Authors: Kita, Yoshiaki, Okumura, Hiroshi, Uchikado, Yasuto, Sasaki, Ken, Omoto, Itaru, Matsumoto, Masataka, Setoyama, Tetsuro, Tanoue, Kiyonori, Mori, Shinichiro, Owaki, Tetsuhiro, Ishigami, Sumiya, Ueno, Shinichi, Kajiya, Yoriko, Natsugoe, Shoji
• Format: Journal Article
• Language: English
• Published: New York Springer-Verlag 01.05.2013
• Subjects: Adult; Aged; Aged, 80 and over; Carcinoma, Squamous Cell - diagnostic imaging; Carcinoma, Squamous Cell - secondary; Carcinoma, Squamous Cell - surgery; Esophageal Neoplasms - diagnostic imaging; Esophageal Neoplasms - pathology; Esophageal Neoplasms - surgery; Esophagectomy; Esophagoscopy; Female; Fluorodeoxyglucose F18; Glucose Transporter Type 1 - metabolism; Humans; Kaplan-Meier Estimate; Lymphatic Metastasis; Lymphatic Vessels - pathology; Male; Medicine; Medicine & Public Health; Middle Aged; Neoplasm Invasiveness; Oncology; Positron-Emission Tomography; Prognosis; Proportional Hazards Models; Radiopharmaceuticals; Surgery; Surgical Oncology; Thoracic Oncology; Esophageal Cancer; Endoscopic Mucosal Resection; Esophageal Squamous Cell Carcinoma Cell; Endoscopic Submucosal Dissection; Esophageal Squamous Cell Carcinoma
• ISSN: 1068-9265; 1534-4681; 1534-4681
• DOI: 10.1245/s10434-012-2796-2

Purpose To assess the clinical usefulness and significance of 18 F-fluorodeoxyglucose positron emission tomography (FDG-PET) in superficial esophageal squamous cell carcinoma (ESCC). Methods We examined FDG-PET for 80 consecutive patients with superficial ESCC without neoadjuvant treatment. Fifty-seven patients underwent radical esophagectomy, and 23 patients received endoscopic resection. The FDG uptake index was evaluated with clinicopathological findings, and glucose transporter 1 (Glut-1) expression in primary tumors was examined immunohistochemically. Results The FDG uptake in primary tumors correlated with histology, depth of tumor invasion, lymph node metastasis, lymphatic invasion, vascular invasion, and Glut-1 expression. All patients with more than 4.4 maximum standardized uptake value (SUV max ) had deeper invasion of submucosa. Among 16 patients with lymph node metastasis, only two were found to have lymph node metastasis. FDG uptake, depth of tumor invasion, lymph node metastasis, and histology were found to be prognostic factors, and histology was an independent prognostic factor. In FDG uptake–positive patients, depth of tumor invasion and histology were prognostic factors. Conclusions FDG-PET is useful for diagnosing tumors with deeper invasion of submucosa and is helpful in making decisions regarding endoscopic treatment for superficial ESCC. Patients with FDG uptake–positive disease, deeper invasion of submucosa, poorly differentiated tumor, and poor prognosis should receive multimodal treatment.