Tumor Response in Esophageal Squamous Cell Carcinoma Treated With Neoadjuvant Chemotherapy Followed by Surgery

Anticancer Res. 2020 Feb;40(2):1153-1160. doi: 10.21873/anticanres.14057.

Abstract

Background/aim: Neoadjuvant therapy followed by surgery is the standard treatment for advanced esophageal cancer. This study aimed to evaluated the potential of 18F-fluorodeoxyglucose positron-emission tomography to predict the pathological therapeutic effect of neoadjuvant chemotherapy.

Patients and methods: We enrolled 68 patients with advanced esophageal squamous cell carcinoma who underwent 18F-fluorodeoxyglucose positron-emission tomography before and after neoadjuvant chemotherapy, followed by surgery. Retrospective analysis of the pathological therapeutic effects was performed.

Results: The pathological therapeutic effect of good responders was significantly inversely associated with the maximum standardized uptake value (SUVmax) after neoadjuvant chemotherapy and with SUVmax reduction (both p<0.0001). Univariate and multivariate analyses revealed that lower post therapy SUVmax and reduction in SUVmax were independent prognostic factors for relapse-free (p=0.02) and overall survival (p<0.0001).

Conclusion: Post-neoadjuvant chemotherapy SUVmax and SUVmax reduction can predict the pathological therapeutic effect of neoadjuvant chemotherapy.

Keywords: Chemotherapy; FDG-PET; SUVmax; esophageal squamous cell carcinoma.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Combined Modality Therapy
  • Esophageal Squamous Cell Carcinoma / diagnosis
  • Esophageal Squamous Cell Carcinoma / mortality
  • Esophageal Squamous Cell Carcinoma / therapy*
  • Esophagectomy* / adverse effects
  • Esophagectomy* / methods
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Multimodal Imaging / methods
  • Neoadjuvant Therapy
  • Neoplasm Grading
  • Neoplasm Staging
  • ROC Curve
  • Treatment Outcome