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Apparent diffusion coefficient values detected by diffusion-weighted imaging in the prognosis of patients with locally advanced esophageal squamous cell carcinoma receiving chemoradiation

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ABSTRACT

Purpose: Previous studies have demonstrated that apparent diffusion coefficient (ADC) values measured by magnetic resonance imaging have prognostic value in patients with esophageal squamous cell carcinoma (ESCC). However, the role of ADC needs to be validated in a cohort of Chinese ESCC patients. This study assessed the role of ADC in predicting the outcome of patients with ESCC treated only by chemoradiation in the People’s Republic of China.

Patients and methods: Seventy-three patients with local advanced ESCC were retrospectively analyzed in this study; none of the patients underwent surgery before or after chemoradiation. The ADC values of the primary tumors were determined by magnetic resonance imaging. The ADC values were then correlated with clinicopathological and other radiological parameters. Survival analysis was carried out to determine if ADC had an impact on survival of these patients.

Results: The median ADC value of the esophageal cancer tissue was 1.256*10−3 mm2/sec (range: 0.657–2.354*10−3 mm2/sec, interquartile range 0.606*10−3 mm2/sec). No clinicopathological or radiological parameters were associated with the ADC values except the sites of tumor tissues. ADC <1.076*10−3 mm2/sec predicted significantly worse survival in patients with ESCC (12.9 months vs undefined, P=0.0108).

Conclusion: The ADC value is a potent prognostic factor which can be used to predict the outcome of patients with ESCC treated only by chemoradiation.

No MeSH data available.


Related in: MedlinePlus

Low ADC value predicted worse survival in patients with ESCC.Notes: Patients with ADC <1.076*10−3 mm2/s had a significantly worse overall survival than those with ADC ≥1.076*10−3 mm2/s.Abbreviations: ADC, apparent diffusion coefficient; OS, overall survival; ESCC, esophageal squamous cell carcinoma.
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f2-ott-9-5791: Low ADC value predicted worse survival in patients with ESCC.Notes: Patients with ADC <1.076*10−3 mm2/s had a significantly worse overall survival than those with ADC ≥1.076*10−3 mm2/s.Abbreviations: ADC, apparent diffusion coefficient; OS, overall survival; ESCC, esophageal squamous cell carcinoma.

Mentions: While using univariate analysis, we found that presence of lymph node metastasis was significantly associated with a worse survival (P=0.014, hazard ratio [HR] 2.826). There was a trend that patients with T4 diseases had a worse prognosis than those with T1–3 diseases (P=0.081), although this difference was not statistically significant. The median survival of the patients who achieved CR was significantly higher than that of patients who did not (P<0.0001, HR =45.7). The survival of cancer of the middle esophagus was worse than that of those from other sites (13.9 months vs undefined), although the difference is not statistically significant (P=0.0537). We determined if ADC was prognostic in our cohort. According to the previous study, we used 1.1*10−3 mm2/sec as the cutoff of ADC; however, the survival between patients with ADC <1.1*10−3 mm2/sec and patients with ADC ≥1.1*10−3 mm2/sec was not significantly different (P=0.1517). We use X-tile to find a cutoff of ADC to best predict the prognosis of these patients.4 Using 1.076 as the cutoff value of ADC, we divided our patients into two groups, we found that the overall survival of patients with ADC <1.076*10−3 mm2/sec was significantly worse than patients with ADC ≥1.076*10−3 mm2/sec (12.9 months vs undefined, P=0.0108, Figure 2). We then determined whether ADC was an independent factor that was predictive of survival. We included age, sex, tumor depth, lymph node metastasis, and ADC into multivariate Cox analysis. In multivariate analysis, ADC <1.076*10−3 mm2/sec was an independent predictor of worse survival in our cohort (Table 2, P=0.014; HR 2.715 [1.226–6.014]).


Apparent diffusion coefficient values detected by diffusion-weighted imaging in the prognosis of patients with locally advanced esophageal squamous cell carcinoma receiving chemoradiation
Low ADC value predicted worse survival in patients with ESCC.Notes: Patients with ADC <1.076*10−3 mm2/s had a significantly worse overall survival than those with ADC ≥1.076*10−3 mm2/s.Abbreviations: ADC, apparent diffusion coefficient; OS, overall survival; ESCC, esophageal squamous cell carcinoma.
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Related In: Results  -  Collection

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getmorefigures.php?uid=PMC5036604&req=5

f2-ott-9-5791: Low ADC value predicted worse survival in patients with ESCC.Notes: Patients with ADC <1.076*10−3 mm2/s had a significantly worse overall survival than those with ADC ≥1.076*10−3 mm2/s.Abbreviations: ADC, apparent diffusion coefficient; OS, overall survival; ESCC, esophageal squamous cell carcinoma.
Mentions: While using univariate analysis, we found that presence of lymph node metastasis was significantly associated with a worse survival (P=0.014, hazard ratio [HR] 2.826). There was a trend that patients with T4 diseases had a worse prognosis than those with T1–3 diseases (P=0.081), although this difference was not statistically significant. The median survival of the patients who achieved CR was significantly higher than that of patients who did not (P<0.0001, HR =45.7). The survival of cancer of the middle esophagus was worse than that of those from other sites (13.9 months vs undefined), although the difference is not statistically significant (P=0.0537). We determined if ADC was prognostic in our cohort. According to the previous study, we used 1.1*10−3 mm2/sec as the cutoff of ADC; however, the survival between patients with ADC <1.1*10−3 mm2/sec and patients with ADC ≥1.1*10−3 mm2/sec was not significantly different (P=0.1517). We use X-tile to find a cutoff of ADC to best predict the prognosis of these patients.4 Using 1.076 as the cutoff value of ADC, we divided our patients into two groups, we found that the overall survival of patients with ADC <1.076*10−3 mm2/sec was significantly worse than patients with ADC ≥1.076*10−3 mm2/sec (12.9 months vs undefined, P=0.0108, Figure 2). We then determined whether ADC was an independent factor that was predictive of survival. We included age, sex, tumor depth, lymph node metastasis, and ADC into multivariate Cox analysis. In multivariate analysis, ADC <1.076*10−3 mm2/sec was an independent predictor of worse survival in our cohort (Table 2, P=0.014; HR 2.715 [1.226–6.014]).

View Article: PubMed Central - PubMed

ABSTRACT

Purpose: Previous studies have demonstrated that apparent diffusion coefficient (ADC) values measured by magnetic resonance imaging have prognostic value in patients with esophageal squamous cell carcinoma (ESCC). However, the role of ADC needs to be validated in a cohort of Chinese ESCC patients. This study assessed the role of ADC in predicting the outcome of patients with ESCC treated only by chemoradiation in the People&rsquo;s Republic of China.

Patients and methods: Seventy-three patients with local advanced ESCC were retrospectively analyzed in this study; none of the patients underwent surgery before or after chemoradiation. The ADC values of the primary tumors were determined by magnetic resonance imaging. The ADC values were then correlated with clinicopathological and other radiological parameters. Survival analysis was carried out to determine if ADC had an impact on survival of these patients.

Results: The median ADC value of the esophageal cancer tissue was 1.256*10&minus;3 mm2/sec (range: 0.657&ndash;2.354*10&minus;3 mm2/sec, interquartile range 0.606*10&minus;3 mm2/sec). No clinicopathological or radiological parameters were associated with the ADC values except the sites of tumor tissues. ADC &lt;1.076*10&minus;3 mm2/sec predicted significantly worse survival in patients with ESCC (12.9 months vs undefined, P=0.0108).

Conclusion: The ADC value is a potent prognostic factor which can be used to predict the outcome of patients with ESCC treated only by chemoradiation.

No MeSH data available.


Related in: MedlinePlus