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RA07.01: CHANGE OF METABOLIC TUMOR VOLUME PREDICTS LONG-TERM SURVIVAL AND HISTOLOGICAL RESPONSE TO PREOPERATIVE CHEMOTHERAPY IN LOCALLY-ADVANCED ESOPHAGEAL CANCER


 
 
 The present study was aimed to assess the value of metabolic tumor volume (MTV) measured by 18F-fluorodeoxyglucose to evaluate response to neoadjuvant chemotherapy in patients with locally-advanced esophageal cancer (EC).
 
 
 
 A total of 102 EC patients without distant metastasis who underwent 18-fluorodeoxyglucose (FDG)-positron emission tomography (PET) both before and after the series of preoperative chemotherapy were analyzed.
 
 
 
 The median value of MTV in primary tumor before and after preoperative chemotherapy were 22.55 (range: 0.4 -183.1) and 2.75 (0–52.9), respectively and the median reduction rate of MTV was 86.5%. The most significant difference in survival between PET responders and non-responders was at 60% of MTV reduction as a cutoff value based on every 10% stepwise cutoff analysis (2-year progression-free survival [PFS]: 79.2 vs 44.4%; hazard ratio [HR] = 3.397; P < 0.0001). With this cutoff value, histological complete response (P = 0.0091) in addition to tumor location (P = 0.0102), pT (P = 0.0011), and pN (P = 0.0110) were significantly associated with PET response. Univariate analysis of PFS indicated a correlation between PFS and tumor size, cT, decrease of primary lesion by CT, SUVmax reduction rate, MTV reduction rate, pT, pN, pM. Multivariate analysis further identified MTV reduction rate (HR = 2.471; P = 0.0263) but not decrease of primary lesion by CT or SUVmax reduction rate to be independent prognostic predictors along with pM (HR = 3.063; P = 0.0279).
 
 
 
 By determining the optimal cutoff value based on survival analysis, change of MTV was shown to be clinically useful in predicting both long-term survival and histological response to preoperative chemotherapy in EC patients.
 
 
 
 All authors have declared no conflicts of interest.
