Pre-treatment Metabolic Tumor Volume and Total Lesion Glycolysis are Useful Prognostic Factors for Esophageal Squamous Cell Cancer Patients

Objectives: To study application of the maximum standardized uptake value (SUVmax), metabolic tumorvolume (MTV) and total lesion glycolysis (TLG) with 18F-FDG PET/CT for predicting prognosis of esophagealsquamous cell cancer (ESC) patients.
Methods: Eighty-six patients with ESC staged from I to IV were prospectivelyenrolled. Cisplatin-based chemoradiotherapy (CCRT) or palliative chemoradiotherapy were the main treatmentmethods and none received surgery. 18F-FDG PET/CT scans were performed before the treatment. SUVmax,MTV, and TLG were measured for the primary esophageal lesion and regional lymph nodes. Receiver operatingcharacteristic curves (ROCs) were generated to calculate the P value of the predictive ability and the optimalthreshold.
Results: MTV and TLG proved to be good indexes in the prediction of outcome for the ESC patients.An MTV value of 15.6 ml and a TLG value of 183.5 were optimal threshold to predict the overall survival (OS).The areas under the curve (AUC) for MTV and TLG were 0.74 and 0.70, respectively. Kaplan-Meier analysisshowed an MTV less than 15.6 ml and a TLG less than 183.5 to indicate good media survival time (p value <0.05).In the stage III-IV patient group, MTV could better predict the OS (P < 0.001), with a sensitivity and specificityof 0.80 and 0.67, respectively.
Conclusions: Pre-treatment MTV and TLG are useful prognostic factors in nonsurgicalESC.