1. ¹Université Paris 12 et Hôpital Henri Mondor, 51 Av du Mal de Lattre de Tassigny, Créteil 94100, France
2. ²Hôpital Saint Antoine, Paris 75012, France
3. ³Hôpital Bichat Claude Bernard, Paris 75018, France
4. ⁴Hôpital Tenon, Paris 75020, France
5. ⁵Hôpital Ambroise Paré, 92 Boulogne, France
6. ⁶Hôpital Saint Louis, Paris 75010, France
7. ⁷Hôpital Lariboisière, Paris 75010, AP-HP, France

Correspondence: 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.

Abstract

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.