Are Patients with Esophageal Cancer Who Become PET Negative after Neoadjuvant Chemoradiation Free of Cancer?

James Mcloughlin, Marcovalerio Melis, Erin M. Siegel, E. Michelle Dean, Jill M. Weber, Jeannie Chern, Melanie Elliott, Scott T. Kelley, Richard C. Karl

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)879-886
Number of pages8
JournalJournal of the American College of Surgeons
Volume206
Issue number5
DOIs
StatePublished - May 1 2008
Externally publishedYes

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Esophageal Neoplasms
Neoplasms
Neoadjuvant Therapy
Research Ethics Committees
Positron-Emission Tomography
Databases
Pathology
Neoplasm Metastasis
Sensitivity and Specificity
Incidence

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Are Patients with Esophageal Cancer Who Become PET Negative after Neoadjuvant Chemoradiation Free of Cancer? / Mcloughlin, James; Melis, Marcovalerio; Siegel, Erin M.; Dean, E. Michelle; Weber, Jill M.; Chern, Jeannie; Elliott, Melanie; Kelley, Scott T.; Karl, Richard C.

In: Journal of the American College of Surgeons, Vol. 206, No. 5, 01.05.2008, p. 879-886.

Research output: Contribution to journalArticle

Mcloughlin, James ; Melis, Marcovalerio ; Siegel, Erin M. ; Dean, E. Michelle ; Weber, Jill M. ; Chern, Jeannie ; Elliott, Melanie ; Kelley, Scott T. ; Karl, Richard C. / Are Patients with Esophageal Cancer Who Become PET Negative after Neoadjuvant Chemoradiation Free of Cancer?. In: Journal of the American College of Surgeons. 2008 ; Vol. 206, No. 5. pp. 879-886.
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