RA07.07: THE ROLE OF 18 F-FLUORODEOXYGLUCOSE POSITRON-EMISSION TOMOGRAPHY ON SURVIVAL OF PATIENTS FOLLOWING NEOADJUVANT CHEMOTHERAPY AND SURGERY FOR ESOPHAGEAL CANCER.

Background The occurrence of lymph node metastases (LNMs) is a critical factor for postoperative survival in patients with esophageal cancer. Generally F-fluorodeoxyglucose positron-emission tomography (FDG-PET) has a low sensitivity and a relatively high rate of false-negative for detecting LNMs. However, the role of FDG-PET in predicting the outcome is still unclear. The aim of this study is to assess the role of FDG-PET in predicting survival in patients with resectable thoracic esophageal squamous cell carcinoma (TESCC) treated with neoadjuvant chemotherapy (NAC). Methods Seventy-three patients with TESCC received NAC followed by surgery, and underwent FDG-PET before NAC in our hospital between January 2012 and November 2016. The number of PET-positive lymph nodes (LNs) and the maximum standardized uptake value (SUVmax) of the LNs were prospectively evaluated. The results of FDG-PET were compared with the pathological results and the prognosis. Results 15 patients had no PET-positive LNs, 23 had one, 15 had two and 20 patients had three or more positive LNs. A significantly high proportion of the PET-positive LNs ≧3 group had ≧3 pathological LNMs than the PET-positive LNs ≦2 group (70.0 vs. 22.6%, P  < 0.001). The PET-positive LNs ≧3 group also had a significantly lower 3-year overall survival rate (47.9 vs. 71.9%, P  = 0.018). Univariate Cox's proportional hazard regression analyses revealed the PET-positive LNs ≧3 status (Hazard ratio = 2.68 [1.14–6.28], P  = 0.024) and the SUVmax of the LNs ≧8 status (Hazard ratio = 2.45 [1.06–5.65], P  = 0.036) were significant prognostic factors. On the other hand, the SUVmax of the primary tumor was not a significant prognostic factor. Conclusion We identified the PET-positive LNs ≧3 status and the SUVmax of the LNs ≧8 status in patients with resectable TESCC before NAC as potential adverse prognostic factors for survival. Disclosure All authors have declared no conflicts of interest. View large Download slide View large Download slide [ABSTRACT FROM AUTHOR]