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Randomized Controlled Trial
. 2008 Mar 11;98(5):875-80.
doi: 10.1038/sj.bjc.6604263. Epub 2008 Feb 26.

Early detection of recurrence by 18FDG-PET in the follow-up of patients with colorectal cancer

I Sobhani  1 , E Tiret, R Lebtahi, T Aparicio, E Itti, F Montravers, C Vaylet, P Rougier, T André, J M Gornet, D Cherqui, C Delbaldo, Y Panis, J N Talbot, M Meignan, D Le Guludec
Affiliations
Randomized Controlled Trial

Early detection of recurrence by 18FDG-PET in the follow-up of patients with colorectal cancer

I Sobhani et al. Br J 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.

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Figures

Figure 1
Figure 1
Study scheme.
Figure 2
Figure 2
Kaplan–Meier curve for time to recurrence detected in patients with curative therapy for colon or rectal cancer.
Figure 3
Figure 3
Kaplan–Meier curve for time to recurrence in asymptomatic patients without elevated tumour marker levels.
See this image and copyright information in PMC

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