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Background: Several previous studies have reported that the FDG standardised uptake value (SUVmax) on PET-CT imaging may be a useful prognostic marker. The majority of these studies have assessed selected populations. The aim of this study was to report the influence of FDG SUVmax on the outcome of an unselected cohort of patients undergoing PET-CT for esophageal carcinoma.
Methods: The SUVmax was determined for 105 patients undergoing PET-CT during the time period 2007-10. Patients were subdivided into quartiles according to SUVmax and its influence on prognosis assessed by univariate and multi-variate analysis.
Results: The study population was 105 patients (77 male) of median age 65 years (range 41-83). Histology was adenocarcinoma in 77 patients, squamous carcinoma in 28. Treatment intent was curative for 64 patients (resection 31, radical chemoradation 31, endoscopic mucosal resection 2) and palliative for the remaining 41 patients. On univariate analysis, SUVmax was not influenced by sex (p=0.08), age (p=0.19), histology (p=0.81) or tumor site (p=0.07), but was heavily linked to UICC stage (p<0.001). Survival was significantly associated with quartile of SUVmax score (p=0.03). This effect disappeared on multivariate analysis because prognosis was so strongly linked to UICC stage (p=0.01). However, subgroup analysis identified that for patients treated by radical chemoradiation, UICC stage (p=0.002) and SUVmax (p=0.01) were the only factors linked to prognosis.
Conclusions: This study did not confirm the FDG SUVmax on PET-CT to offer additional prognostic information for most patients with esophageal carcinoma. It may be helpful in patients treated by primary chemoradiation.