The value of post-neoadjuvant therapy PET-CT in the detection of interval metastases in esophageal carcinoma.
Eur J Surg Oncol
; 37(9): 774-8, 2011 Sep.
Article
em En
| MEDLINE
| ID: mdl-21726976
ABSTRACT
BACKGROUND:
PET-CT scanning is increasingly applied in the primary work-up of esophageal cancer patients. The additional value of a second PET-CT after completion of neoadjuvant therapy (NT) prior to surgery is presently unclear. Therefore, a consecutive series of esophageal cancer patients underwent PET-CT scanning after completion of NT for evaluation of metastatic disease that became manifest under NT.METHODS:
A consecutive series of patients planned for curative esophagectomy who underwent a PET-CT prior to and after NT were included in this study. Neoadjuvant therapy consisted of 5FU and cisplatinum combined with 50.4Gy radiotherapy. The first PET-CT was performed as part of the diagnostic work-up, the second PET-CT was performed after completion of NT and prior to surgery. Median interval between NT and second PETCT was 6 weeks. In case of metastatic disease on the post-neoadjuvant therapy PET-CT confirmed by a biopsy, patients were excluded from surgical resection.RESULTS:
Between November 2008 and July 2010 a total of 50 patients underwent first and second PET-CT scanning. 80% of patients was diagnosed with adenocarcinoma, 18% with squamous cell carcinoma. Confirmed metastatic disease on the second PET-CT was present in 4/50 patients (8%). These patients were excluded from resection. A false-positive diagnosis concerning a pulmonary lesion was present in 1 patient (2%); this infiltrate had disappeared on follow up imaging.DISCUSSION:
This study showed development of metastatic disease during NT detected by PET-CT in 8% of esophageal cancer patients, suggesting an additional value of a second PET-CT in order to prevent unnecessary surgical resections.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Neoplasias Esofágicas
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Tomografia Computadorizada por Raios X
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Terapia Neoadjuvante
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Tomografia por Emissão de Pósitrons
Tipo de estudo:
Diagnostic_studies
Limite:
Aged
/
Aged80
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Female
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Humans
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Male
/
Middle aged
Idioma:
En
Revista:
Eur J Surg Oncol
Assunto da revista:
NEOPLASIAS
Ano de publicação:
2011
Tipo de documento:
Article
País de afiliação:
Holanda