Document Detail


Are patients with esophageal cancer who become PET negative after neoadjuvant chemoradiation free of cancer?
MedLine Citation:
PMID:  18471715     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Esophageal cancer continues to increase in incidence. Many patients are presenting with stage II or greater disease and proceeding to neoadjuvant chemoradiation therapy before resection. Approximately 30% of patients will achieve a complete response and might not benefit from proceeding to resection. This study will examine the ability of PET to predict patients with a complete pathologic response. STUDY DESIGN: A query of our IRB-approved esophageal database revealed 81 patients who underwent a pre- and postchemoradiation PET scan and then proceeded to esophageal resection. Statistical analysis was performed to determine the ability of PET to predict a complete pathologic response. RESULTS: When comparing posttherapy PET with final pathology, it was determined that PET could not consistently differentiate a complete pathologic response from patients who still had persistent disease. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 61.8%, 43.8%, 70%, 35%, and 56%, respectively, for patients with a complete PET response after neoadjuvant therapy. CONCLUSIONS: A complete PET response after neoadjuvant chemoradiation is not substantially predictive of a complete pathologic response. Patients should still be referred for resection unless distant metastases are identified.
Authors:
James M McLoughlin; Marcovalerio Melis; Erin M Siegel; E Michelle Dean; Jill M Weber; Jeannie Chern; Melanie Elliott; Scott T Kelley; Richard C Karl
Related Documents :
8988735 - 18-fluorodeoxyglucose uptake and survival of patients with suspected recurrent malignan...
9662595 - Use of carbon-11 methionine positron emission tomography to assess malignancy grade and...
23055215 - Photodynamic therapy in cholangiocarcinoma.
14564185 - Lack of usefulness of anti-transglutaminase antibodies in assessing histologic recovery...
16805825 - Phase ii study of the cpt-11, mitoxantrone and dexamethasone regimen in combination wit...
18479425 - Favorable response to analgesics does not predict a benign etiology of headache.
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of the American College of Surgeons     Volume:  206     ISSN:  1879-1190     ISO Abbreviation:  J. Am. Coll. Surg.     Publication Date:  2008 May 
Date Detail:
Created Date:  2008-05-12     Completed Date:  2008-05-29     Revised Date:  2009-05-21    
Medline Journal Info:
Nlm Unique ID:  9431305     Medline TA:  J Am Coll Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  879-86; discussion 886-7     Citation Subset:  AIM; IM    
Affiliation:
Department of Surgery, Medical College of Georgia, Augusta, GA, USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Antineoplastic Agents / administration & dosage*
Esophageal Neoplasms / pathology,  radionuclide imaging*,  therapy*
Female
Humans
Male
Middle Aged
Neoadjuvant Therapy
Positron-Emission Tomography*
Predictive Value of Tests
Radiotherapy
Remission Induction
Chemical
Reg. No./Substance:
0/Antineoplastic Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Role for extending hepatic resection using an aggressive approach to liver surgery.
Next Document:  Parathyroid exploration in the reoperative neck: improved preoperative localization with 4D-computed...