The Role of Maximum Standardized Uptake Value in PET/CT as a Prognostic Factor in Patients with Resected Esophageal Squamous Cell Carcinoma

Abstract

Background: The aim of this study was to evaluate the role of the maximum standardized uptake value (mSUV) of the main mass as a risk factor for recurrence in patients with completely resected esophageal squamous cell carcinoma (ESCC). Patients and Methods: Clinicopathologic factors including primary tumor location, tumor size, depth of tumor invasion, number of positive lymph nodes, angiolymphatic invasion, and mSUV were analyzed as risk factors for recurrence. The prognostic influence of variables on disease-free survival was analyzed using the log-rank test for univariate analysis and the Cox proportional hazards model for multivariate analysis. Results: A total of 102 patients underwent complete resection of ESCC and positron emission tomography/computed tomography was performed. The median follow-up period was 35.0 months (range, 2-94). The average mSUV of the main mass was 5.5 +/- 4.2. The tumor had recurred in 38 patients (37.3%). Univariate analysis identified that tumor size (> 3.5 cm), depth of tumor invasion (>= T2), pathologic stage, and mSUV (> 5.1) were statistically significant prognostic factors for recurrence of ESCC. However, in multivariate analysis, only mSUV (> 5.1, HR = 4.222, p = 0.025) was the independent risk factor of recurrence. Conclusions: The mSUV of the main mass was an independent predictor for recurrence with a cutoff value of 5.1.