The influence of 18flourodeoxyglucose positron emission tomography on the management of gastroesophageal junction carcinoma

Smith, Jason W.; Moreira, Jonathan; Abood, Gerard; Aranha, Gerard V.; Nagda, Suneel; Wagner, Robert H.; Shoup, Margo

doi:10.1016/j.amjsurg.2008.10.010

« Previous Next »The American Journal of Surgery
Volume 197, Issue 3 , Pages 308-312, March 2009

The influence of ¹⁸flourodeoxyglucose positron emission tomography on the management of gastroesophageal junction carcinoma

Jason W. Smith, M.D.
- Department of Surgery, Loyola University Medical Center, Maywood, IL, USA
Jonathan Moreira, B.S.
- Department of Surgery, Loyola University Medical Center, Maywood, IL, USA
Gerard Abood, M.D.
- Department of Surgery, Loyola University Medical Center, Maywood, IL, USA
Gerard V. Aranha, M.D., F.R.C.S.C., FACS
- Department of Surgery, Loyola University Medical Center, Maywood, IL, USA
Suneel Nagda, M.D.
- Department of Radiation Oncology, Loyola University Medical Center, Maywood, IL, USA
Robert H. Wagner, M.D.
- Department of Nuclear Medicine, Loyola University Medical Center, Maywood, IL, USA
Margo Shoup, M.D., FACS
- Department of Surgery, Loyola University Medical Center, Maywood, IL, USA
- Corresponding author. Tel.: +01-708-327-3430; fax: +01-708-327-3565

Received 4 August 2008; received in revised form 15 October 2008

Abstract

Background

The influence of positron emission tomography (PET) scanning with flourodeoxyglucose (FDG) on decision making for the treatment of patients with esophagogastric junction (EGJ) carcinoma is unclear as is the utility of the maximum standardized uptake value (SUV) as a prognostic indicator.

Methods

This study was a retrospective review of EGJ carcinoma cases at a single institution during a 5-year period.

Results

FDG-PET altered treatment in 13 of 64 patients (20%). Of these, 21 patients had PET scans before and after undergoing neoadjuvant chemoradiation (CRT) as well as surgery. Patients who had a decrease in SUV >50% had a 12-month disease-free survival advantage over patients a decrease in SUV <50% (93% vs 43%, P = .025).

Conclusions

FDG-PET alters treatment in a significant number of patients with EGJ carcinoma. A >50% decrease in SUV after CRT is associated with an improved prognosis.

Keywords: Esophageal carcinoma, Esophagectomy, Esophagogastric junction, FDG-JPET, Gastric carcinoma