Document Detail


The early use of PET-CT alters the management of patients with esophageal cancer.
MedLine Citation:
PMID:  19184245     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: The routine use of positron emission tomography-computed tomography (PET-CT) in the staging of patients with esophageal carcinoma remains contentious, with conflicting reports of its benefit. In our unit, PET-CT has been used routinely in the staging of all patients considered for radical therapy (surgery or chemoradiotherapy). Our aim was to determine the frequency with which PET-CT influenced decision making in the management of patients with carcinoma of the esophagus or gastroesophageal junction. METHODS: CT, PET-CT, and outcome information were collected on 38 patients considered for radical therapy. Patient proformas, with and without PET-CT findings, were constructed and each independently reviewed in a randomized and blinded fashion by five multidisciplinary team members (three surgeons, two oncologists) and a treatment strategy determined. RESULTS: PET-CT changed the staging for ten patients (26%). This translated into a change in management decision for seven patients (18%). The concordance between individual management plans and treatment intent was 79% for CT (150 of 190 decisions) and it was 92% for PET-CT (175 of 190 decisions). Full concordance between multidisciplinary team members was 66% with CT staging and 74% with the addition of PET-CT. CONCLUSION: The use of PET-CT early in the staging algorithm for esophageal carcinoma altered the staging for a quarter of patients and the management for a fifth of patients, supporting its inclusion early in the staging algorithm.
Authors:
R N Williams; S S Ubhi; C D Sutton; A L Thomas; J J Entwisle; D J Bowrey
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial     Date:  2009-01-28
Journal Detail:
Title:  Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract     Volume:  13     ISSN:  1873-4626     ISO Abbreviation:  J. Gastrointest. Surg.     Publication Date:  2009 May 
Date Detail:
Created Date:  2009-04-13     Completed Date:  2009-07-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9706084     Medline TA:  J Gastrointest Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  868-73     Citation Subset:  IM    
Affiliation:
Department of Surgery, Leicester Royal Infirmary, University Hospital of Leicester NHS Trust, Leicester, UK.
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MeSH Terms
Descriptor/Qualifier:
Adenocarcinoma / pathology*,  therapy
Adult
Aged
Aged, 80 and over
Algorithms
Carcinoma, Squamous Cell / pathology*,  therapy
Cohort Studies
Early Detection of Cancer
Esophageal Neoplasms / pathology*,  therapy
Female
Humans
Male
Middle Aged
Neoplasm Staging / methods*
Patient Selection
Positron-Emission Tomography*
Predictive Value of Tests
Tomography, X-Ray Computed*

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


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