BACKGROUND: Esophageal cancer continues to increase in incidence. Many patients are presenting with stage II or greater disease and proceeding to neoadjuvant chemoradiation therapy before resection. Approximately 30% of patients will achieve a complete response and might not benefit from proceeding to resection. This study will examine the ability of PET to predict patients with a complete pathologic response. STUDY DESIGN: A query of our IRB-approved esophageal database revealed 81 patients who underwent a pre- and postchemoradiation PET scan and then proceeded to esophageal resection. Statistical analysis was performed to determine the ability of PET to predict a complete pathologic response. RESULTS: When comparing posttherapy PET with final pathology, it was determined that PET could not consistently differentiate a complete pathologic response from patients who still had persistent disease. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 61.8%, 43.8%, 70%, 35%, and 56%, respectively, for patients with a complete PET response after neoadjuvant therapy. CONCLUSIONS: A complete PET response after neoadjuvant chemoradiation is not substantially predictive of a complete pathologic response. Patients should still be referred for resection unless distant metastases are identified.
BACKGROUND:Esophageal cancer continues to increase in incidence. Many patients are presenting with stage II or greater disease and proceeding to neoadjuvant chemoradiation therapy before resection. Approximately 30% of patients will achieve a complete response and might not benefit from proceeding to resection. This study will examine the ability of PET to predict patients with a complete pathologic response. STUDY DESIGN: A query of our IRB-approved esophageal database revealed 81 patients who underwent a pre- and postchemoradiation PET scan and then proceeded to esophageal resection. Statistical analysis was performed to determine the ability of PET to predict a complete pathologic response. RESULTS: When comparing posttherapy PET with final pathology, it was determined that PET could not consistently differentiate a complete pathologic response from patients who still had persistent disease. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 61.8%, 43.8%, 70%, 35%, and 56%, respectively, for patients with a complete PET response after neoadjuvant therapy. CONCLUSIONS: A complete PET response after neoadjuvant chemoradiation is not substantially predictive of a complete pathologic response. Patients should still be referred for resection unless distant metastases are identified.
Authors: Arta Monir Monjazeb; Greg Riedlinger; Mebea Aklilu; Kim R Geisinger; Girish Mishra; Scott Isom; Paige Clark; Edward A Levine; A William Blackstock Journal: J Clin Oncol Date: 2010-09-27 Impact factor: 44.544
Authors: Navesh K Sharma; Joshua S Silverman; Tianyu Li; Jonathan Cheng; Jian Q Yu; Oleh Haluszka; Walter Scott; Neal J Meropol; Steven J Cohen; Gary M Freedman; Andre A Konski Journal: Gastrointest Cancer Res Date: 2011-05
Authors: Charlotte I Stroes; Sandor Schokker; Aafke Creemers; Remco J Molenaar; Maarten C C M Hulshof; Stephanie O van der Woude; Roel J Bennink; Ron A A Mathôt; Kausilia K Krishnadath; Cornelis J A Punt; Rob H A Verhoeven; Martijn G H van Oijen; Geert-Jan Creemers; Grard A P Nieuwenhuijzen; Maurice J C van der Sangen; Laurens V Beerepoot; Joos Heisterkamp; Maartje Los; Marije Slingerland; Annemieke Cats; Geke A P Hospers; Maarten F Bijlsma; Mark I van Berge Henegouwen; Sybren L Meijer; Hanneke W M van Laarhoven Journal: J Clin Oncol Date: 2019-12-06 Impact factor: 44.544
Authors: Nabil P Rizk; Elliot L Servais; Laura H Tang; Camelia S Sima; Hans Gerdes; Martin Fleisher; Valerie W Rusch; Prasad S Adusumilli Journal: Cancer Epidemiol Biomarkers Prev Date: 2012-01-11 Impact factor: 4.254