Document Detail


Does the use of diagnostic PET/CT cause stage migration in patients with primary advanced ovarian cancer?
MedLine Citation:
PMID:  20042226     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To investigate if the use of diagnostic FDG-PET/CT leads to stage migration in patients with advanced ovarian cancer and to evaluate the prognostic significance of FDG-PET/CT. METHODS: From September 2004 to August 2007, 201 patients with a Risk of Malignancy Index (RMI) >150 based on serum CA-125, ultrasound examinations and menopausal state, underwent PET/CT within 2 weeks prior to standard surgery/debulking of a pelvic tumor. On 15 August, 2009 overall survival and prognostic variables were analysed in 66 ovarian cancer patients (64 stage III and 2 stage IV). RESULTS: Median follow-up was 30.2 months; median age was 62.5 years (range 35-85 years); 97% (64/66) had a performance status <or=2; 38% (25/66) underwent complete debulking (no macroscopic residual tumor); 51% (39/66) was diagnosed with PET/CT stage III and 41% (27/66) was diagnosed with PET/CT stage IV. Survival was significantly longer for patients with PET/CT stage III than for patients with PET/CT stage IV (P=0.03). Using univariate analysis, PET/CT stage III (P=0.03), complete debulking (no macroscopic residual tumor) (P=0.002), and GOG performance status <or=2 (P=0.04) were statistically significant prognostic variables. Using multivariate Cox regression analysis, complete debulking was the only statistically significant independent prognostic variable (P=0.02). CONCLUSION: In primary advanced ovarian cancer the use of diagnostic FDG-PET/CT leads to stage migration. Adequate staging is the foundation for ovarian cancer treatment and advanced imaging for optimal evaluation of metastases should be promoted in clinical trials. The strongest determinant of patient outcome is residual abdominal tumor after primary surgery.
Authors:
S Risum; C H?gdall; A Loft; A K Berthelsen; E H?gdall; L Nedergaard; L Lundvall; S A Engelholm
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Publication Detail:
Type:  Clinical Trial; Journal Article     Date:  2009-12-29
Journal Detail:
Title:  Gynecologic oncology     Volume:  116     ISSN:  1095-6859     ISO Abbreviation:  Gynecol. Oncol.     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-02-15     Completed Date:  2010-03-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0365304     Medline TA:  Gynecol Oncol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  395-8     Citation Subset:  IM    
Affiliation:
Department of Oncology, the Finsen Center, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. signerisum@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
CA-125 Antigen / blood
Female
Fluorodeoxyglucose F18 / diagnostic use*
Humans
Middle Aged
Neoplasm Staging
Ovarian Neoplasms / blood,  pathology,  radionuclide imaging*,  surgery
Positron-Emission Tomography / methods*
Prognosis
Prospective Studies
Radiopharmaceuticals / diagnostic use*
Survival Rate
Chemical
Reg. No./Substance:
0/CA-125 Antigen; 0/Radiopharmaceuticals; 63503-12-8/Fluorodeoxyglucose F18

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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