Impact of PET-CT on primary staging and response control on multimodal treatment of XXXX .

@entity1 @entity5 @entity900 @entity189 @entity418 @entity420 @entity1487
BACKGROUND: The predictive value of positron emission tomography-computed tomography (PET-CT) in primary staging and response control in @entity1 with @entity418 ( @entity418 ) is under discussion. In the present study initial staging and metabolic response of PET-CT was correlated with @entity5 regression and survival in @entity1 with multimodal treatment of @entity418 . METHODS: The authors conducted a retrospective analysis on a prospective database for 83 @entity1 with @entity418 (42 squamous cell, 39 @entity420 , 2 @entity189 ) undergoing PET-CT for primary staging. Twenty-four of the @entity1 underwent primary esophagectomy, 9 had palliative treatment, and 50 neoadjuvant radiochemotherapy ( @entity900 , @entity1487 ; 50.4 Gy). The PET-CT study was repeated 6 weeks after induction of chemotherapy and compared with endoscopic ultrasound (EUS). For response control, the metabolic response ( @entity5 standardized uptake value [SUV] reduction) was correlated with histopathologic (ypT0-4) and histomorphologic response ( @entity5 regression) and survival. RESULTS: At primary staging 81 of 83 @entity418 (97.5%) showed an increased SUV uptake correlating with the EUS @entity5 stage. Suspicious lymph nodes were detected in 51 (61.4%) @entity1 by PET-CT and 66 (79.5%) were detected by EUS. Fifteen @entity1 had additional findings on PET-CT examination leading to a change in therapy in 9 @entity1 (10.3%). Of 50 @entity1 receiving a second PET-CT study, a SUV reduction >50% correlated with major histomorphologic response ( @entity5 regression grade 4, <10% vital @entity5 cells) and histopathologic response (ypT0 ypN0). Furthermore, these @entity1 showed a significantly increased survival (33.1    3.5 months) compared to non-responders (21.7    3.3 months; p = 0.02) and @entity1 after primary surgery (29    3.2 months; p = 0.05). CONCLUSIONS: The present study shows that PET-CT is a valuable tool for primary staging and response control in multimodal treatment of @entity1 with @entity418 .
