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British Journal of Cancer (2008) 98, 875-880.
doi:10.1038/sj.bjc.6604263 www.bjcancer.com Published online 26 February 2008
Early detection of recurrence by 18FDG-PET in the follow-up of patients with colorectal cancer
I Sobhani1, E Tiret2, R Lebtahi3, T Aparicio3, E Itti1, F Montravers4, C Vaylet2, P Rougier5, T André4, J M Gornet6, D Cherqui1, C Delbaldo1, Y Panis7, J N Talbot4, M Meignan1 and D Le Guludec3
1Université Paris 12 et Hôpital Henri Mondor, 51 Av du Mal de Lattre de Tassigny, Créteil 94100, France
2Hôpital Saint Antoine, Paris 75012, France
3Hôpital Bichat Claude Bernard, Paris 75018, France
4Hôpital Tenon, Paris 75020, France
5Hôpital Ambroise Paré, 92 Boulogne, France
6Hôpital Saint Louis, Paris 75010, France
7Hôpital Lariboisière, Paris 75010, AP-HP, France
Correspondence to: Professor I Sobhani, E-mail: iradj.sobhani@hmn.aphp.fr
Received 14 November 2007; revised 10 January 2008; accepted 17 January 2008; published online 26 February 2008
We assessed the potential benefits of including systematic 18fluorodeoxyglucose positron emission tomography (FDG-PET) for detecting tumour recurrence in a prospective randomised trial. Patients (N=130) who had undergone curative therapy were randomised to undergo either conventional (Con) or FDG-PET procedures during follow-up. The two groups were matched at baseline. Recurrence was confirmed histologically. 'Intention-to-treat' analysis revealed a recurrence in 46 patients (25 in the FDG-PET group, and 21 in the Con group; P=0.50), whereas per protocol analysis revealed a recurrence in 44 out of 125 patients (23 and 21, respectively; P=0.60). In another three cases, PET revealed unexpected tumours (one gastric GIST, two primary pulmonary cancers). Three false-positive cases of FDG-PET led to no beneficial procedures (two laparoscopies and one liver MRI that were normal). We failed to identify peritoneal carcinomatosis in two of the patients undergoing FDG-PET. The overall time in detecting a recurrence from the baseline was not significantly different in the two groups. However, recurrences were detected after a shorter time (12.1 vs 15.4 months; P=0.01) in the PET group, in which recurrences were also more frequently (10 vs two patients) cured by surgery (R0). Regular FDG-PET monitoring in the follow up of colorectal cancer patients may permit the earlier detection of recurrence, and influence therapy strategies.
Keywords: FDG PET; CT scan; colon cancer; follow up
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| Print ISSN: 0007-0920 | Online ISSN: 1532-1827 | © 2008 Cancer Research UK | ||
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