RESUMO
BACKGROUND: The role of (18)F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) in prostate cancer (PCa) has not been well defined yet. Because high-grade PCa tends to exhibit increased glycolytic rate, FDG-PET/CT could be useful in this setting. The aim of this study was to assess the value of FDG-PET/CT for pre-operative staging and prognostic stratification of patients with high-grade PCa at biopsy. METHODS: Fifty-four patients with a Gleason sum≥8 PCa at biopsy underwent FDG-PET/CT as part of the staging workup. Thirty-nine patients underwent radical prostatectomy (RP) and pelvic lymph node (LN) dissection, 2 underwent LN dissection only, and 13 underwent non-surgical treatments. FDG-PET/CT findings from clinical reports, blinded reading and quantitative analysis were correlated with clinico-pathological characteristics at RP. RESULTS: Suspicious foci of increased FDG uptake were found in the prostate, LNs and bones in 44, 13 and 6% of patients, respectively. Higher clinical stage, post-RP Gleason sum and pattern, and percentage of cancer involvement within the prostate were significantly associated with the presence of intraprostatic FDG uptake (IPFU) (P<0.05 in all cases). Patients without IPFU who underwent RP were downgraded to Gleason≤7 in 84.6% of cases, as compared to 30.8% when IPFU was reported (P=0.003). Qualitative and quantitative IPFU were significantly positively correlated with post-RP Gleason pattern and sum, and pathological T stage. Absence and presence of IPFU were associated with a median 5-year cancer-free survival probability of 70.2 and 26.9% (P=0.0097), respectively, using the CAPRA-S prognostic tool. CONCLUSION: These results suggest that, among patients with a high-grade PCa at biopsy, FDG-PET/CT could improve pre-treatment prognostic stratification by predicting primary PCa pathological grade and survival probability following RP.
Assuntos
Adenocarcinoma/diagnóstico , Fluordesoxiglucose F18 , Tomografia por Emissão de Pósitrons/métodos , Neoplasias da Próstata/patologia , Tomografia Computadorizada por Raios X , Adenocarcinoma/metabolismo , Idoso , Osso e Ossos/metabolismo , Humanos , Linfonodos/metabolismo , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Prognóstico , Neoplasias da Próstata/metabolismo , Compostos RadiofarmacêuticosAssuntos
Redes de Comunicação de Computadores/organização & administração , Necessidades e Demandas de Serviços de Saúde , Relações Interinstitucionais , Encaminhamento e Consulta/organização & administração , Documentação , Humanos , Registro Médico Coordenado/métodos , Quebeque , Programas Médicos Regionais/organização & administraçãoRESUMO
This article reviews the methods used to implement computer-based training via a hospital intranet. Extensive consultation with the members of the Nursing Staff Development Team throughout the five campuses and a close working relationship with Information Services contributed to the success of the project. This article could serve as a valuable resource for nurses who are interested in using hospital intranets for learning.