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ORIGINAL ARTICLE
Year : 2014  |  Volume : 10  |  Issue : 1  |  Page : 121-126

PET-CT changes the management and improves outcome in patients with recurrent colorectal cancer


1 Department of Clinical Oncology, University of Akdeniz, Akdeniz School of Medicine, Antalya, Turkey
2 Department of Medical Oncology, Sisli Education and Research Hospital, Istanbul, Turkey
3 Department of Nuclear Medicine, University of Istanbul, Cerrahpasa Medical Faculty, Istanbul, Turkey
4 University of Istanbul, Cerrahpasa Medical Faculty, Medical Student, Istanbul, Turkey
5 Department of Medical Oncology, University of Medipol, School of Medicine; Department of Internal Medicine, Division of Medical Oncology, Istanbul, Turkey
6 University of Istanbul, Cerrahpasa Medical Faculty, Division of Medical Oncology, Istanbul, Turkey

Correspondence Address:
Emre Akar
Istanbul University, Cerrahpasa Medical Faculty, TR-34098 Istanbul
Turkey
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0973-1482.131445

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Background: The present study aims to analyze the impact of positron emission tomography/computed tomography (PET/CT) on management change in patients with suspected or proven colorectal cancer recurrence, and to assess the effect of this management change on progression-free survival (PFS) and overall survival (OS). Materials and Methods: We retrospectively evaluated 122 patients with suspected potentially resectable recurrent colorectal cancer who underwent PET/CT scan. We determined management plans for these patients before and after the PET/CT examination. Results: While previous conventional imaging studies had revealed solitary metastases, additional sites of disease were determined by PET/CT scan in 52/122 (42%) patients. PET/CT examination results changed the treatment plan to curative intent in 35 (37%) patients. While the median PFS was 22 months (95% CI, 11.2-32.6 months) among the patients planned to receive curative treatment after the PET/CT scan, it was 11 months (95% CI, 8.1-13.9 months) in patients planned to receive curative treatment before the PET/CT examination, and the difference between median PFS durations was statistically significant (HR, 0.51 [95% CI, 0.32 - 0.88], P = 0.004). Furthermore, OS was significantly longer in patients planned to receive curative treatment after the PET/CT scan (27 months [95% CI, 22.1-31.9]) compared with those who received curative treatment before the PET/CT scan (21 months [95% CI, 15.6 - 26.4]), and the difference was statistically significant (HR, 0.63 [95% CI, 0.42 - 0.89], P = 0.045). Conclusion: The present study demonstrates the significant impact of PET/CT on the management and outcome in patients with recurrent colorectal cancer.

Abstract in Chinese

PET-CT对复发结直肠癌病人治疗策略及改善预后的作用 背景:目前的研究主要分析正电子发射计算机断层显像/计算机断层扫描(PET/CT)在可疑或确认的复发结直肠癌病人中的影响,评价其处理方法改变后无进展生存时间(PFS)和总生存时间(OS)的影响。 材料和方法:回顾性分析122例可疑的潜在可切除的结直肠癌术后复发病例,均接受过PET/CE扫描。我们分别在PET/CT扫描前后为这些病人决定治疗计划。 结果:52/122(42%)病例仅靠传统的影像学检查显示单个转移灶,而PET/CT扫描发现额外的病灶。通过PET/CT检查结果改变治疗计划的病例有35例(37%)。经过PET/CT扫描后计划接受治愈性治疗的病人中,中位PFS22个月(95%置信区间:11.2~32.6个月),未行PET/CT扫描而计划行治愈性治疗的病人中,中位PFS11个月(95%置信区间:8.1~13.9个月),统计学有显著性差异(HR, 0.51 [95% CI:0.32 ~ 0.88], P = 0.004)。另外,OS也有明显延长:PET/CT组为27个月([95% CI:22.1~31.9]),非PET/CT组为21个月([95% CI:15.6~26.4]),有显著统计学差异(HR, 0.63[95% CI:0.42~0.89], P = 0.045)。 结论:研究表明PET/CT扫描对复发结直肠癌病人的处理方法和结果有明显影响。 关键词:改进的结果,治疗策略的改变,复发结直肠癌,正电子发射计算机断层显像/计算机断层扫描



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