title: Early detection of recurrence by 18FDG-PET in the follow-up of patients with colorectal cancer.
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.
authors.affiliation: Université Paris 12 et Hôpital Henri Mondor, 51 Av du Mal de Lattre de Tassigny, Créteil 94100, France. iradj.sobhani@hmn.aphp.fr
authors.forename: I
authors.initials: I
authors.lastname: Sobhani
authors.forename: E
authors.initials: E
authors.lastname: Tiret
authors.forename: R
authors.initials: R
authors.lastname: Lebtahi
authors.forename: T
authors.initials: T
authors.lastname: Aparicio
authors.forename: E
authors.initials: E
authors.lastname: Itti
authors.forename: F
authors.initials: F
authors.lastname: Montravers
authors.forename: C
authors.initials: C
authors.lastname: Vaylet
authors.forename: P
authors.initials: P
authors.lastname: Rougier
authors.forename: T
authors.initials: T
authors.lastname: André
authors.forename: J M
authors.initials: JM
authors.lastname: Gornet
authors.forename: D
authors.initials: D
authors.lastname: Cherqui
authors.forename: C
authors.initials: C
authors.lastname: Delbaldo
authors.forename: Y
authors.initials: Y
authors.lastname: Panis
authors.forename: J N
authors.initials: JN
authors.lastname: Talbot
authors.forename: M
authors.initials: M
authors.lastname: Meignan
authors.forename: D
authors.initials: D
authors.lastname: Le Guludec
mesh_terms: D000328:Adult; D000368:Aged; D015179:Colorectal Neoplasms / Q000000981:diagnostic imaging*; D019788:Fluorodeoxyglucose F18; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging*; D049268:Positron-Emission Tomography; D011446:Prospective Studies
chemical_list: D019788:Fluorodeoxyglucose F18