Prognostic value of baseline FDG uptake on PET-CT in esophageal carcinoma

Table 1 Influence of patient characteristics on maximum standardized uptake value and survival

Factor	Mean SUVmax (95%CI)	Median survival in days (95%CI)
Sex
Male (n = 191)	11.4 (10.5, 12.3)	566 (491, 641)
Female (n = 80)	12.1 (10.2, 14.0)	884 (403, 1364)
	P = 0.950	P = 0.05
Age in years
Age ≤ 65 (n = 136)	11.5 (10.5, 12.5)	575 (456, 694)
Age > 65 (n = 135)	11.7 (10.4, 13.1)	586 (418, 754)
	P = 0.770	P = 0.25
Histology
Adenocarcinoma (n = 197)	11.3 (10.2, 12.4)	570 (483, 657)
Squamous carcinoma (n = 74)	12.4 (11.3, 13.6)	629 (445, 813)
	P = 0.008	P = 0.75
Tumor location
Upper esophagus (n = 13)	15.6 (11.4, 19.8)	973 (142,1804)
Mid esophagus (n = 50)	12.8 (11.0, 14.6)	425 (252, 598)
Lower esophagus (n = 136)	10.8 (9.6, 12.0)	586 (464, 708)
Junctional (n = 72)	11.6 (10.0, 13.1)	684 (430, 938)
	P = 0.010	P = 0.14

SUV_max: Maximum standardized uptake value.

Table 2 Influence of cancer stage on maximum standardized uptake value and survival

Factor	Mean SUVmax (95%CI)	Median survival in days (95%CI)
T stage
T0 or T1 (n = 15)	3.1 (1.5, 4.7)	Not reached
T2 (n = 49)	8.7 (7.0, 10.4)	1225 (742, 1708)
T3 (n = 183)	12.7 (11.7, 13.7)	495 (413, 577)
T4 (n = 24)	14.1 (11.6, 16.7)	390 (186, 594)
	P < 0.001	P < 0.001
N stage
N0 (n = 107)	9.1 (8.1, 10.2)	1094 (835, 1352)
N1 (n = 89)	12.9 (11.4, 14.5)	466 (371, 561)
N2 (n = 61)	13.4 (11.6, 15.1)	477 (307, 646)
N3 (n = 14)	14.4 (8.8, 19.9)	530 (350, 710)
	P < 0.001	P < 0.001
UICC stage
Stage 0 or 1 (n = 45)	5.6 (4.2, 7.0)	2092 (1060, 3124)
Stage 2 (n = 50)	12.1 (10.6, 13.6)	780 (195,1365)
Stage 3 (n = 99)	11.9 (10.7, 13.2)	594 (473, 715)
Stage 4 (n = 77)	14.4 (12.6, 16.1)	349 (280, 418)
	P < 0.001	P < 0.001

SUV_max: Maximum standardized uptake value; UICC: Union for International Cancer Control.

Table 3 Influence of treatment intent and modality on maximum standardized uptake value and survival

Factor	Mean SUVmax (95%CI)	Median survival in days (95%CI)
Treatment intention
Curative (n = 182)	10.6 (9.7, 11.5)	984 (699, 1269)
Palliative (n = 89)	13.6 (11.9, 15.2)	370 (332, 408)
	P = 0.001	P < 0.001
Treatment type
Endoscopic resection (n = 5)	1.3 (-1.0, 3.6)	Not reached
Surgical resection (n = 95)	10.7 (9.5, 11.9)	1285 (962, 1608)
Chemoradiotherapy (n = 63)	11.6 (10.0, 13.1)	700 (411, 988)
Palliative (n = 89)	13.8 (12.1, 15.5)	370 (349, 390)
Exploratory surgery (n = 19)	8.8 (6.6, 11.0)	340 (280, 400)
	P < 0.001	P < 0.001

SUV_max: Maximum standardized uptake value.

Table 4 Summary of literature reporting on prognostic value of maximum standardized uptake value in patients with esophageal carcinoma

Ref.	Patients (n)	Adeno-carcinoma (%)	Treatment intention of studied group	Median (or mean) SUVmax	SUVmax significant on univariate analysis	SUVmax significant on multivariate analysis	Other significant associations on multivariate analysis
Fukunaga et al[4], 1998	48	Not stated	Curative	7	Yes	Not assessed	Not assessed
Choi et al[5], 2004	69	0%	Curative	6.3/13.7 (thresholds)	Yes	No	UICC stage
Hong et al[6], 2005	47	87%	Curative	Not stated	No	No	Number of abnormalities on PET-CT
Stahl et al[7], 2005	40	100%	Curative	10.5	No	Not assessed
van Westreenen et al[8], 2005	40	70%	Curative and palliative	6.7	Yes	No	Treatment
Cerfolio et al[9], 2006	89	53%	Curative	6.6	Yes	Yes	UICC stage
Choi et al[10], 2006	51	0%	Curative	Not stated	Yes	No	UICC stage, N1 status (on PET-CT), immunohistochemical markers
Westerterp et al[11], 2008	26	100%	Curative	0.26	Yes	Not assessed
Omloo et al[12], 2008	125	85%	Curative	0.27	Yes	No	UICC stage
Cheze-Le Rest et al[13], 2008	47	77%	Curative	9	Yes	Yes	Treatment, number of abnormalities on PET-CT
Chatterton et al[14], 2008	129	19%	Curative and palliative	8.2	No	Not assessed	Not assessed
Makino et al[15], 2008	38	100%	Curative	11.1	Yes	No	N1 status (on PET-CT)
Javeri et al[16], 2009	161	100%	Curative	10.1	No	No
Kato et al[17], 2009	184	0%	Curative	4.5	Yes	Yes	N1 status
Rizk et al[18], 2009	189	100%	Curative	4.5 (preset threshold)	Yes	Not assessed	Not assessed
Sepesi et al[19], 2009	72	83%	Curative	6.2	Yes	Yes
Shenfine et al[20], 2009	45	100%	Curative	5.7	Yes	No	UICC stage
Hyun et al[21], 2010	151	3%	Curative and palliative	17.2	Yes	No	UICC stage, metabolic tumor volume
Brown et al[22], 2012	103	80%	Curative	6.4 (early)/8.8 (later scans)	Yes	No	N1 status, age
Gillies et al[23], 2012	121	100%	Curative	8.5	Yes	No	N1 status (on PET-CT)
Chan et al[24], 2013	185	75%	Curative and palliative	8.9	Yes	No	N1 status, tumor volume on EUS

SUV_max: Maximum standardized uptake value; UICC: Union for International Cancer Control; PET-CT: Positron emission tomography-computed tomography.