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Ann Thorac Surg 2006;81:1082
© 2006 The Society of Thoracic Surgeons

Original article: General thoracic

Invited commentary

Jeffrey M. Piehler, MD

Department of Cardiothoracic Surgery, University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS 66160

(Email: jpiehler@kumc.edu).

The first 20% of the full text of this article appears below.

Positron emission tomography (PET) scanning with 18F-FDG has significantly contributed to the management of esophageal cancer. This modality has a widely accepted benefit: (1) in the initial clinical staging of the disease, particularly regarding the detection of distant metastatic foci, (2) in the delineation of targets for radiation therapy, (3) in the assessment of response to neoadjuvant therapy with associated prognostic implications, and (4) in the detection and restaging of recurrence. An additional benefit of PET scanning is proposed by this provocative article by Rizk and colleagues [1] in that 18F-FDG-PET derived maximal standard uptake values (SUVmax) of the untreated primary tumor at presentation are strongly predictive of stage, and independently of survival.

Similar observations have been made for other malignancies, including lung cancer, but data pertaining to esophageal cancer have been sparse, particularly because of the confounding effects of neoadjuvant or adjuvant therapy, or both, which are currently offered to the majority of patients with the disease. The authors have appropriately selected out those patients . . . [Full Text of this Article]






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