gms | German Medical Science

27th German Cancer Congress Berlin 2006

German Cancer Society (Frankfurt/M.)

22. - 26.03.2006, Berlin

Final report of assessment of response to neoadjuvant radiochemotherapy in esophageal squamous cell carcinoma patients by 18-FDG-PET

Meeting Abstract

  • corresponding author presenting/speaker Björn Brücher - Chirurgische Klinik und Poliklinik, TU München, Deutschland
  • Hinrich Wieder - Institut für Nuklearmedizin, TU München
  • Karen Becker - Institut für Pathologie, TU München
  • Wolfgang Weiss - Institut für Radiologie, TU München
  • Raymonde Busch - Institut für Statistik und Epidemiologie, TU München
  • Florian Lordick - Chirurgische Klinik und Poliklinik, TU München
  • Hubert Stein - Chirurgische Klinik und Poliklinik, TU München
  • Frank Zimmermann - Institut für Strahlentherapie, TU München
  • Michael Molls - Institut für Strahlentherapie, TU München
  • Ulrich Fink - Chirurgische Klinik und Poliklinik, TU München
  • Markus Schwaiger - Institut für Nuklearmedizin, TU München
  • Jörg-Rüdiger Siewert - Chirurgische Klinik und Poliklinik, TU München

27. Deutscher Krebskongress. Berlin, 22.-26.03.2006. Düsseldorf, Köln: German Medical Science; 2006. DocOP173

The electronic version of this article is the complete one and can be found online at:

Published: March 20, 2006

© 2006 Brücher et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Purpose: Positron emission tomography with the glucose analog [18F]-fluorodeoxyglucose (FDG-PET) has been used for response evaluation in patients with esophageal squamous cell carcinoma (ESCC) after neoadjuvant radiochemotherapy (RTx/CTx). This prospective study was undertaken to compare FDG-PET assessment of tumor response to RTx/CTx with endoscopy computed tomography (CT), and histopathology in patients with ESCC, and to correlate the findings with survival and recurrence.

Patients and Methods: One hundred five patients with histologically proven ESCC (cT3, cN0/+, cM0) underwent preoperative, simultaneous RTx/CTx followed by esophagectomy between 1996 and 2004. The patients underwent endoscopy, CT and FDG-PET prior to and 3–4 weeks after completion of RTx/CTx. Response assessed by endoscopy and CT was classified by WHO criteria. Histopathological response was quantified as the percentage of residual tumor cells. The threshold pre-therapy-to-post-therapy decrease in standardized uptake value by FDG-PET used to define metabolic responders (∆SUVR) was –52%, as previously reported.

Results: Responders by FDG-PET (p=0.002) as well as Histopathology (p<0.0001) showed substantially better survival than nonresponders in contrast to endoscopy (p=0.6) or CT (p=0.1). Univariate as well as multivariate regression analysis revealed histopathological (p<0.0001) and FDG-PET response (p=0.015) to be independent predictive factors for survival. No correlation between response measured by endoscopy, Spiral-CT, or histopathology and the median recurrence-free-interval was found. FDG-PET responders showed a significantly longer median recurrence-free-interval compared to nonresponders (p=0.04).

Conclusions: Changes in tumor metabolic activity by FDG-PET are independent predictive for survival after neoadjuvant RTx/CTx in ESCC. FDG-PET responders show a longer recurrence-free interval compared to nonresponders.