Comparison of 18FDG-PET/CT and conventional follow-up methods in colorectal cancer: A randomised prospective study |
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| Authors: | Jacques Monteil Valerie Le Brun-Ly Florent Cachin Xavier Zasadny Jean-François Seitz Olivier Mundler Marie Selvy Denis Smith Eric Rullier Sandrine Lavau-Denes Guillaume Lades Anais Labrunie Cedric Lecaille Nathalie Valli Sophie Leobon Eric Terrebonne Elise Deluche Nicole Tubiana-Mathieu |
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| Affiliation: | 1. Department of Nuclear Medicine, University Hospital, Limoges, France;2. Department of Medical Oncology, University Hospital, Limoges, France;3. Department of Nuclear Medicine, Jean Perrin Cancer Institute, Clermont-Ferrand, France;4. Department of Radiotherapy, François Chénieux Clinic, Limoges, France;5. Department of Oncology and Hepato-Gastroenterology, University Hospital La Timone, Marseille, France;6. Department of Nuclear Medicine, University Hospital La Timone, Marseille, France;7. Department of Digestive Surgery and Oncology, Estaing Hospital, Clermont-Ferrand, France;8. Department of Digestive Oncology, University Hospital Saint André, Bordeaux, France;9. Department of Digestive Surgery, University Hospital Saint André, Bordeaux, France;10. Department of Biostatistics and Clinical Research, University Hospital, Limoges, France;11. Department of Gastroenterology and Digestive Oncology, Bordeaux Nord Polyclinic, Bordeaux, France;12. Department of Nuclear Medicine, Bordeaux Nord Polyclinic, Bordeaux, France;13. Department of Gastroenterology and Digestive Oncology, University Hospital Haut-Lévêque, Bordeaux, France |
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| Abstract: | BackgroundA surveillance program was performed in colorectal cancer (CRC) patients after surgery, to diagnose asymptomatic recurrence.AimsTo assess whether 18-FDG positron emission tomography/CT (PET/CT) improved the detection of recurrence during a 3-year follow-up.MethodsA multicentre, two-arm randomised prospective trial comparing different 36-month follow-up strategies. Complete colonoscopy was performed at baseline and after 3 years and clinical exams with imaging every 3 months. The conventional arm (A) received carcinoembryonic antigen, liver echography, and alternated between lung radiography and computed tomography (CT) scans. The experimental arm (B) received PET/CT.ResultsA total of 365 patients with colon (79.4%) or rectal cancer (20.6%), stages II (48.2%) or III (50.8%), were enroled in this study. At 36 months, intention-to-treat analysis revealed recurrence in 31 (17.2%) patients in arm A and 47 (25.4%) in arm B (p = 0.063). At 3 years, 7 of 31 relapses (22.5%) in arm A were surgically treated with curative intent, compared to 17 of 47 (36.2%) in arm B (p = 0.25). The rates of recurrence and new cancers were higher in arm B than arm A (p = 0.038).ConclusionsPET/CT follow-up every 6 months did not increase the rate of recurrence at 3 years or the rate of surgically treated recurrence compared with conventional follow-up. |
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