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Title: PET changes management and improves prognostic stratification in patients with recurrent colorectal cancer: results of a multicenter prospective study.
Austin Authors: Scott, Andrew M ;Gunawardana, Dishan H;Kelley, Ben;Stuckey, John G;Byrne, Amanda J;Ramshaw, Jayne E;Fulham, Michael J
Affiliation: Centre for PET, Austin Hospital, Melbourne, Australia
Issue Date: 14-Aug-2008
Publication information: Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine 2008; 49(9): 1451-7
Abstract: The aims of our study were to examine the impact of PET in changing management in patients with proven or suspected colorectal cancer recurrence and to assess the impact of management change on disease-free survival.Symptomatic patients with a residual structural lesion suggestive of recurrent tumor (group A) or patients with pulmonary or hepatic metastases considered to be potentially resectable (group B) underwent PET scans. Pre-PET management plans were documented by referring clinicians unaware of the PET results, and follow-up to 12 mo was performed to determine actual management and clinical outcomes.A total of 191 patients (118 men and 73 women; mean age, 66 y) were studied. PET detected additional sites of disease in 48.4% of patients in group A and in 43.9% of patients in group B. A change in planned management was documented in 65.6% of group A and in 49.0% of group B patients. These management plans were implemented in 96% of patients. Follow-up data in group A showed progressive disease in 60.5% of patients with additional lesions detected by PET, compared with conventional imaging, and in 36.2% of patients with no additional lesions detected by PET (P=0.04). In group B, progressive disease was identified in 65.9% of patients with additional lesions detected by PET and in 39.2% of patients with no additional lesions detected by PET (P=0.01). PET also provided valuable prognostic information on patients stratified into curative- or palliative-intent groups.These data demonstrate the significant impact of PET on management and outcomes in patients with suspected recurrent colorectal cancer.
Gov't Doc #: 18703607
DOI: 10.2967/jnumed.108.051615
Journal: Journal of Nuclear Medicine
Type: Journal Article
Subjects: Australia.epidemiology
Colorectal Neoplasms.epidemiology.radionuclide imaging.therapy
Neoplasm Recurrence, Local.epidemiology.prevention & control.radionuclide imaging
Outcome Assessment (Health Care).methods
Physician's Practice Patterns.statistics & numerical data
Positron-Emission Tomography.statistics & numerical data
Prospective Studies
Reproducibility of Results
Risk Assessment.methods
Risk Factors
Sensitivity and Specificity
Treatment Outcome
Appears in Collections:Journal articles

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