[Follow-up after curative surgery for colorectal cancer: impact of positron emission tomography - computed tomography (PET/CT)].
Postoperative surveillance has an important role in patient survival after curative resection of colorectal cancer.


OBJECTIVE
To describe the characteristics of the follow-up with positron emission tomography (PET) / computed tomography (CT)(PET/CT) and its impact in colorectal cancer (CRC) survivors after curative resection in a university hospital in Tochigi Prefecture, Japan.


METHODS
Consecutive review of patient's hospital charts who underwent presurgical staging with PET/CT for curative resection of colorectal cancer between April 2005 and March 2008. The follow-up data of these patients was reviewed until September 2008.


RESULTS
Of 209 patients presurgically staged for CRC, 207 (male/female = 125/82; mean age = 65.3 ± 11.3 years) underwent curative resection and were included in the present study. The compliance rate with the Japanese Society for Cancer of the Colon and Rectum (JSCCR) follow-up guidelines was 53%. The cumulative survival at the end of study interval was 96.4%. The test most commonly used in postoperative follow-up of CRC was the carcinoembryonic antigen (CEA). PET/CT was the test that detected more patients with recurrent lesions (n = 11, positive predictive value = 23.4), including one patient with an asymptomatic curable recurrence (inguinal lymph node metastasis), also being the most effective test (2.1%). However, its high cost makes it the less cost-effective.


CONCLUSIONS
The use of PET/CT in the postoperative follow-up after curative resection in CRC has proven to be an individualized and effective alternative in the finding of asymptomatic disease curable. Systematic CEA tests with contrast-enhanced CT as a first line of screening and PET/CT as a second line may be an alternative follow up approach after curative resection for CRC.
Centro de PET, Universidad Médica de Dokkyo, Mibu, Japón.
Gustavo
G
Kishimoto
Koji
K
Murakami
Sergio A
SA
Con
Erena
E
Yamasaki
Yasushi
Y
Domeki
Masahiro
M
Tsubaki
Setsu
S
Sakamoto
D000230:Adenocarcinoma / Q000175:diagnosis* / Q000601:surgery*; D000368:Aged; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D049268:Positron-Emission Tomography; D012074:Remission Induction; D014057:Tomography, X-Ray Computed