| Neoadjuvant chemotherapy affects staging of colorectal liver metastasis-a comparison of PET, CT and intraoperative ultrasound. | |
| | |
MedLine Citation:
|
PMID: 20960208 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
|
PURPOSE: Surgery for colorectal liver metastasis facilitates long-term survival, and neoadjuvant chemotherapy improves resectability but may also alter staging accuracy. The aim of this study was to evaluate the effects of neoadjuvant chemotherapy on the efficacy of positron emission tomography (PET), PET-computed tomography (CT), CT and intraoperative ultrasound (IUS) in the detection of liver metastasis. METHODS: Between January 2007 and January 2010, 34 patients with resectable colorectal liver metastasis were included in this retrospective analysis. Seventeen patients had received neoadjuvant chemotherapy. PET or PET-CT, CT or magnetic resonance imaging (MRI) and IUS were performed in all patients. Sensitivity, specificity, positive predictive value and negative predictive value were analysed. Histopathological examination of the resected specimens served as standard reference. RESULTS: A total of 109 liver segments were resected, of which 50 showed no metastatic involvement (45.9%). For patients without systemic chemotherapy, sensitivities for PET, CT/MRI and IUS were 92%, 64% and 100% respectively as compared with 63%, 65% and 94% for patients after neoadjuvant chemotherapy in a segment-based analysis. For PET, standardised uptake values were decreased by 3.9 in 10 patients after chemotherapy whereas lesion diameters were similar (3.0 vs. 3.2 cm). Additional metastases were detected by IUS in seven patients resulting in a change of operative procedure in 20.6%. CONCLUSION: Staging accuracy of colorectal liver metastasis is influenced by neoadjuvant chemotherapy. For PET, decreased tumour metabolism rather than downsizing may account for a drop in sensitivity after neoadjuvant chemotherapy. IUS is critical to avoid incomplete resections. |
| | |
Authors:
|
Johann Spatz; G Holl; J Sciuk; M Anthuber; H M Arnholdt; B Märkl |
Related Documents
:
|
17428168 - Is 18f fdg pet-ct cost effective in lung cancer? 18025508 - Pet/ct of esophageal cancer: its role in clinical management. 19914978 - Pet/ct-guided percutaneous biopsy of isolated intramuscular metastases from postcricoid... 19039558 - 18f-fdg-pet in patients with malignant lymphoma having long-term follow-up: staging and... 8638238 - Cine-mode magnetic resonance imaging of a thoracic intradural arachnoid cyst: case report. 1987608 - Cerebral venography with mr. |
Publication Detail:
|
Type: Journal Article Date: 2010-10-20 |
Journal Detail:
|
Title: International journal of colorectal disease Volume: 26 ISSN: 1432-1262 ISO Abbreviation: Int J Colorectal Dis Publication Date: 2011 Feb |
Date Detail:
|
Created Date: 2011-01-21 Completed Date: - Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 8607899 Medline TA: Int J Colorectal Dis Country: Germany |
Other Details:
|
Languages: eng Pagination: 165-71 Citation Subset: IM |
Affiliation:
|
Department of General, Visceral and Transplantation Surgery, Klinikum Augsburg, Stenglinstr. 2, 86156, Augsburg, Germany, johann.spatz@klinikum-augsburg.de. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Role of surgical resection in colorectal lung metastases: analysis of 137 patients.
Next Document: Inhibition of permeability transition pore opening by mitochondrial STAT3 and its role in myocardial...