• Ann. Oncol. · Nov 2013

    Results of the baseline positron emission tomography can customize therapy of localized esophageal adenocarcinoma patients who achieve a clinical complete response after chemoradiation.

    • A Suzuki, L Xiao, T Taketa, K Sudo, R Wadhwa, M A Blum, H Skinner, R Komaki, B Weston, J H Lee, M S Bhutani, D C Rice, D M Maru, J Erasmus, S G Swisher, W L Hofstetter, and J A Ajani.
    • Department of Gastrointestinal Medical Oncology.
    • Ann. Oncol. 2013 Nov 1; 24 (11): 2854-9.

    BackgroundPatients with localized esophageal adenocarcinoma (EAC) who achieve a clinical complete response (clinCR) after preoperative chemoradiation (trimodality therapy; TMT) or definitive chemoradiation (bimodality therapy; BMT) live longer than those who achieve a MethodsWe analyzed 323 EAC patients, from our prospective database, who achieved a clinCR. Various statistical methods were used to assess the influence of iSUV on patient outcome.ResultsThe median follow-up of 323 patients was 40.8 months [95% confidence interval (CI) 35.6-47.3 months]. Two hundred six (63.8%) patients had TMT and 117 (36.2%) had BMT. If iSUV was ≥6, TMT patients had a longer median OS (94.8 months; 95% CI 66.07-NA) than BMT patients (31.4 months; 95% CI 21.7-42.1; P ≤ 0.001). However, if iSUV was <6, the median OS of TMT and BMT patients was similar (P = 0.62). iSVU did not influence the pathologic complete response rate in TMT patients (P = 0.85).ConclusionclinCR patients with iSUV of <6 are identified as a new subset that fared equally well when treated with TMT or BMT. Future esophageal preservation strategy may be best suited for this newly identified subset of EAC patients.

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