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Endoscopy 2008; 40(6): 464-471
DOI: 10.1055/s-2008-1077302
Original article

© Georg Thieme Verlag KG Stuttgart · New York

Importance of fluorodeoxyglucose-positron emission tomography (FDG-PET) and endoscopic ultrasonography parameters in predicting survival following surgery for esophageal cancer

J.  M.  T.  Omloo1 , G.  W.  Sloof2 , R.  Boellaard3 , O.  S.  Hoekstra3 , P.  L.  Jager4 , H.  M.  van Dullemen5 , P.  Fockens6 , J.  T.  M.  Plukker7 , J.  J.  B.  van Lanschot1
  • 1Department of Surgery, Academic Medical Centre at the University of Amsterdam, Amsterdam, The Netherlands
  • 2Department of Nuclear Medicine, Academic Medical Centre at the University of Amsterdam, Amsterdam,
  • 3Department of Nuclear Medicine and PET Research, VU Medical Centre, Amsterdam, The Netherlands
  • 4Department of Nuclear Medicine, University Medical Centre Groningen, Groningen, The Netherlands
  • 5Department of Gastroenterology, University Medical Centre Groningen, Groningen, The Netherlands
  • 6Department of Gastroenterology, Academic Medical Centre at the University of Amsterdam, Amsterdam, The Netherlands
  • 7Department of Surgery, University Medical Centre Groningen, Groningen, The Netherlands
Further Information

Publication History

submitted 2 October 2007

accepted after revision 5 February 2008

Publication Date:
09 June 2008 (online)

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Commentaire de travail de J. M. T. Omloo et al., pp. 464Endoscopy 2008; 40(06): 544-544
DOI: 10.1055/s-0032-1306839

Background and study aims: To assess the prognostic importance of standardized uptake value (SUV) for 18F-fluorodeoxyglucose (FDG) at positron emission tomography (PET) and of EUS parameters, in esophageal cancer patients primarily treated by surgery.

Patients and methods: Between October 2002 and August 2004 a prospective cohort study involved 125 patients, with histologically proven cancer of the esophagus, without evidence of distant metastases or locally irresectable disease based on extensive preoperative work-up, and fit to undergo major surgery. Follow-up was complete until October 2006, ensuring a minimal potential follow-up of 25 months.

Results: The median SUV was 0.27 (interquartile range 0.13 - 0.45), and was used as cutoff value between high (n = 62) and low (n = 63) SUV. Patients with a high SUV had a significantly worse disease-specific survival compared with patients with a low SUV (P = 0.04). Tumor location (P = 0.005), EUS T stage (P < 0.001), EUS N stage (P = 0.006) and clinical stage (P < 0.006) were also associated with disease-specific survival. However, in multivariate analysis only EUS T stage appeared to be of independent prognostic significance (P = 0.007).

Conclusion: In esophageal cancer patients, EUS T stage, EUS N stage, location and SUV of the primary tumor are pretreatment factors that are associated with disease-specific survival. However, only EUS T stage is an independent prognostic factor.

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J. M. T. Omloo, MD 

Department of Surgery
Academic Medical Centre/University of Amsterdam

Meibergdreef 9
1105 AZ Amsterdam, the Netherlands

Fax: +31-20-6914858

Email: j.m.omloo@amc.uva.nl