| The early use of PET-CT alters the management of patients with esophageal cancer. | |
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MedLine Citation:
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PMID: 19184245 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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R N Williams; S S Ubhi; C D Sutton; A L Thomas; J J Entwisle; D J Bowrey |
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Publication Detail:
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Type: Journal Article; Randomized Controlled Trial Date: 2009-01-28 |
Journal Detail:
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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:
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Created Date: 2009-04-13 Completed Date: 2009-07-22 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9706084 Medline TA: J Gastrointest Surg Country: United States |
Other Details:
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Languages: eng Pagination: 868-73 Citation Subset: IM |
Affiliation:
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Department of Surgery, Leicester Royal Infirmary, University Hospital of Leicester NHS Trust, Leicester, UK. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adenocarcinoma
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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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