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Preoperative Radiation Response Evaluated by 18-Fluorodeoxyglucose Positron Emission Tomography Predicts Survival in Locally Advanced Rectal Cancer

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Diseases of the Colon & Rectum

Purpose

This study focuses on the prognostic survival value of postirradiation metabolic activity in primary rectal cancer as measured with 18-fluorodeoxyglucose positron emission tomography.

Methods

From July 1995 to March 2002, all 59 patients underwent two series of fluorodeoxyglucose positron emission tomography: one before preoperative radiation (standardized uptake values-1), and the other two to three weeks after radiation (standardized uptake values-2). Standardized uptake values-1 and standardized uptake values-2 correspond to before and after radiation, respectively.

Results

In univariate analysis, the following emerged as significant prognostic variables: with or without residual tumor, pathologic differentiation, with or without recurrence, standardized uptake values-2, and with or without lymph node metastases. In multivariate analysis, residual tumor and standardized uptake values-2 were significant prognostic factors for survival. The median survival and the five-year overall survival rate comparing standardized uptake values-2 values <5 vs. >5 were 95 vs. 42 months and 70 vs. 44 percent, respectively (P = 0.042).

Conclusion

A significant survival benefit was observed in patients with low fluorodeoxyglucose uptake after preoperative radiotherapy in primary tumors of rectal cancer.

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Author information

Authors and Affiliations

  1. Department of Radiology, University of Tokyo Hospital, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan

    Keiichi Nakagawa M.D., Hideomi Yamashita M.D., Naoki Nakamura M.D., Hiroshi Igaki M.D., Masao Tago M.D., Toshimitsu Momose M.D. & Kuni Ohtomo M.D.

  2. Department of Surgical Oncology, University of Tokyo Hospital, Tokyo, Japan

    Yoshio Hosoi M.D. & Hirokazu Nagawa M.D.

  3. Department of Surgical Oncology, The Cancer Institute Hospital, Tokyo, Japan

    Tetsuichiro Muto M.D.

Authors
  1. Keiichi Nakagawa M.D.
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  2. Hideomi Yamashita M.D.
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  4. Hiroshi Igaki M.D.
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  5. Masao Tago M.D.
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  6. Yoshio Hosoi M.D.
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  7. Toshimitsu Momose M.D.
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  8. Kuni Ohtomo M.D.
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Correspondence to Keiichi Nakagawa M.D..

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Nakagawa, K., Yamashita, H., Nakamura, N. et al. Preoperative Radiation Response Evaluated by 18-Fluorodeoxyglucose Positron Emission Tomography Predicts Survival in Locally Advanced Rectal Cancer. Dis Colon Rectum 51, 1055–1060 (2008). https://doi.org/10.1007/s10350-008-9243-2

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  • DOI: https://doi.org/10.1007/s10350-008-9243-2

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