Influence of sarcopenia, clinical data, and 2-[18F] FDG PET/CT in outcome prediction of patients with early-stage adenocarcinoma esophageal cancer

Reut Anconina, Claudia Ortega, Ur Metser, Zhihui Amy Liu, Chihiro Suzuki, Micheal McInnis, Gail E. Darling, Rebecca Wong, Kirsty Taylor, Jonathan Yeung, Eric X. Chen, Carol J. Swallow, Jaspreet Bajwa, Raymond W. Jang, Elena Elimova, Patrick Veit-Haibach

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: To determine the prognostic value of sarcopenia measurements done on staging 2-[18F] FDG PET/CT together with metabolic activity of the tumor in patients with adenocarcinoma esophagogastric cancer with surgical treatment. Methods: Patients with early-stage, surgically treated esophageal adenocarcinoma and available pre-treatment 2-[18F] FDG PET/CT were included. The standard uptake value (SUV) and SUV normalized by lean body mass (SUL) were recorded. Skeletal muscle index (SMI) was measured at the L3 level on the CT component of the PET/CT. Sarcopenia was defined as SMI < 34.4cm2/m2 in women and < 45.4cm2/m2 in men. Results: Of the included 145 patients. 30% were sarcopenic at baseline. On the univariable Cox proportional hazards analysis, ECOG, surgical T and N staging, lymphovascular invasion (LVI) positive lymph nodes, and sarcopenia were significant prognostic factors concerning RFS and OS. On multivariable Cox regression analysis, surgical N staging (p = 0.025) and sarcopenia (p = 0.022) remained significant poor prognostic factors for OS and RFS. Combining the clinical parameters with the imaging-derived nutritional evaluation of the patient but not metabolic parameters of the tumor showed improved predictive ability for OS and RFS. Conclusion: Combining the patients’ imaging-derived sarcopenic status with standard clinical data, but not metabolic parameters, offered an overall improved prognostic value concerning OS and RFS.

Original languageEnglish
Pages (from-to)1012-1020
Number of pages9
JournalEuropean Journal of Nuclear Medicine and Molecular Imaging
Volume49
Issue number3
DOIs
StatePublished - 1 Feb 2022
Externally publishedYes

Keywords

  • Esophageal adenocarcinoma
  • Outcome prediction
  • PET/CT
  • Sarcopenia

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