BACKGROUND: PET-CT scanning is increasingly applied in the primary work-up of esophageal cancer patients. The additional value of a second PET-CT after completion of neoadjuvant therapy (NT) prior to surgery is presently unclear. Therefore, a consecutive series of esophageal cancer patients underwent PET-CT scanning after completion of NT for evaluation of metastatic disease that became manifest under NT. METHODS: A consecutive series of patients planned for curative esophagectomy who underwent a PET-CT prior to and after NT were included in this study. Neoadjuvant therapy consisted of 5FU and cisplatinum combined with 50.4Gy radiotherapy. The first PET-CT was performed as part of the diagnostic work-up, the second PET-CT was performed after completion of NT and prior to surgery. Median interval between NT and second PETCT was 6 weeks. In case of metastatic disease on the post-neoadjuvant therapy PET-CT confirmed by a biopsy, patients were excluded from surgical resection. RESULTS: Between November 2008 and July 2010 a total of 50 patients underwent first and second PET-CT scanning. 80% of patients was diagnosed with adenocarcinoma, 18% with squamous cell carcinoma. Confirmed metastatic disease on the second PET-CT was present in 4/50 patients (8%). These patients were excluded from resection. A false-positive diagnosis concerning a pulmonary lesion was present in 1 patient (2%); this infiltrate had disappeared on follow up imaging. DISCUSSION: This study showed development of metastatic disease during NT detected by PET-CT in 8% of esophageal cancer patients, suggesting an additional value of a second PET-CT in order to prevent unnecessary surgical resections.
BACKGROUND: PET-CT scanning is increasingly applied in the primary work-up of esophageal cancerpatients. The additional value of a second PET-CT after completion of neoadjuvant therapy (NT) prior to surgery is presently unclear. Therefore, a consecutive series of esophageal cancerpatients underwent PET-CT scanning after completion of NT for evaluation of metastatic disease that became manifest under NT. METHODS: A consecutive series of patients planned for curative esophagectomy who underwent a PET-CT prior to and after NT were included in this study. Neoadjuvant therapy consisted of 5FU and cisplatinum combined with 50.4Gy radiotherapy. The first PET-CT was performed as part of the diagnostic work-up, the second PET-CT was performed after completion of NT and prior to surgery. Median interval between NT and second PETCT was 6 weeks. In case of metastatic disease on the post-neoadjuvant therapy PET-CT confirmed by a biopsy, patients were excluded from surgical resection. RESULTS: Between November 2008 and July 2010 a total of 50 patients underwent first and second PET-CT scanning. 80% of patients was diagnosed with adenocarcinoma, 18% with squamous cell carcinoma. Confirmed metastatic disease on the second PET-CT was present in 4/50 patients (8%). These patients were excluded from resection. A false-positive diagnosis concerning a pulmonary lesion was present in 1 patient (2%); this infiltrate had disappeared on follow up imaging. DISCUSSION: This study showed development of metastatic disease during NT detected by PET-CT in 8% of esophageal cancerpatients, suggesting an additional value of a second PET-CT in order to prevent unnecessary surgical resections.
Authors: Peter S N van Rossum; Cai Xu; David V Fried; Lucas Goense; Laurence E Court; Steven H Lin Journal: Transl Cancer Res Date: 2016-08 Impact factor: 1.241
Authors: John M Findlay; Richard S Gillies; James M Franklin; Eugene J Teoh; Greg E Jones; Sara di Carlo; Fergus V Gleeson; Nicholas D Maynard; Kevin M Bradley; Mark R Middleton Journal: Eur Radiol Date: 2016-02-16 Impact factor: 5.315
Authors: Bo Jan Noordman; Joel Shapiro; Manon Cw Spaander; Kausilia K Krishnadath; Hanneke Wm van Laarhoven; Mark I van Berge Henegouwen; Grard Ap Nieuwenhuijzen; Richard van Hillegersberg; Meindert N Sosef; Ewout W Steyerberg; Bas Pl Wijnhoven; J Jan B van Lanschot Journal: JMIR Res Protoc Date: 2015-06-29
Authors: Lucas Goense; Jelle P Ruurda; Brett W Carter; Penny Fang; Linus Ho; Gert J Meijer; Richard van Hillegersberg; Wayne L Hofstetter; Steven H Lin Journal: Eur J Nucl Med Mol Imaging Date: 2018-04-16 Impact factor: 9.236
Authors: Maarten C J Anderegg; Elisabeth J de Groof; Suzanne S Gisbertz; Roel J Bennink; Sjoerd M Lagarde; Jean H G Klinkenbijl; Marcel G W Dijkgraaf; Jacques J G H M Bergman; Maarten C C M Hulshof; Hanneke W M van Laarhoven; Mark I van Berge Henegouwen Journal: PLoS One Date: 2015-11-03 Impact factor: 3.240
Authors: Peter S N van Rossum; David V Fried; Lifei Zhang; Wayne L Hofstetter; Linus Ho; Gert J Meijer; Brett W Carter; Laurence E Court; Steven H Lin Journal: Eur J Nucl Med Mol Imaging Date: 2016-08-11 Impact factor: 9.236