Christian Philipp Reinert1, Julia Sekler2, Christian la Fougère3, Christina Pfannenberg2, Sergios Gatidis2. 1. Department of Radiology, Diagnostic and Interventional Radiology, University Hospital Tuebingen, Hoppe-Seyler-Str.3, 72076, Tuebingen, Germany. christian.reinert@med.uni-tuebingen.de. 2. Department of Radiology, Diagnostic and Interventional Radiology, University Hospital Tuebingen, Hoppe-Seyler-Str.3, 72076, Tuebingen, Germany. 3. Department of Radiology, Nuclear Medicine, University Hospital Tuebingen, Hoppe-Seyler-Str.3, 72076, Tuebingen, Germany.
Abstract
OBJECTIVE: To evaluate the impact of PET/CT on clinical management in patients with cancer of unknown primary (CUP). METHODS: A cohort of patients with CUP undergoing PET/CT was prospectively enrolled in a local PET/CT registry study between April 2013 and June 2018. Questionnaire data from referring physicians on intended patient management prior and after PET/CT were recorded including items on the intended treatment concept and intended additional diagnostics. Changes in management after PET/CT were recorded. Patient outcome of different cohorts was analyzed for overall survival drawn from patient records. RESULTS: One hundred fifty-five patients (53 female; 63.4 ± 12.1 years) were included. Intended therapeutic management was revised in 45.8% of patients after PET/CT, including major changes affecting the intended treatment goal in 26.5% of patients and minor changes (therapy adjustments) in 19.3% of patients. Invasive and additional diagnostic procedures were intended in 25.8% and 63.2% prior PET/CT and 13.5% and 6.5% after PET/CT. PET/CT-based curative therapy concepts were associated with significantly longer patient survival (4.7 ± 0.3 years) than palliative therapy concepts (1.8 ± 0.5 years, p = .0001). Patients with cervical CUP showed a significantly longer survival (4.3 ± 0.3 years) than patients with extracervical CUP (3.5 ± 0.5 years, p = .01). The identification of the primary did not significantly affect survival. CONCLUSION: This registry study confirms previous studies reporting that PET/CT significantly influences clinical management in patients with CUP, helping physicians to select a more individualized treatment and to avoid additional diagnostics. Furthermore, we could confirm that tumor localization and extent as shown by PET/CT have a significant impact on patient prognosis. KEY POINTS: • PET/CT significantly influences intended clinical management in patients with CUP, helping physicians to select a more individualized treatment and to avoid additional diagnostics. • Tumor localization and extent as shown by PET/CT have a significant impact on patient prognosis. • The identification of the primary tumor has no significant impact on overall patient survival.
OBJECTIVE: To evaluate the impact of PET/CT on clinical management in patients with cancer of unknown primary (CUP). METHODS: A cohort of patients with CUP undergoing PET/CT was prospectively enrolled in a local PET/CT registry study between April 2013 and June 2018. Questionnaire data from referring physicians on intended patient management prior and after PET/CT were recorded including items on the intended treatment concept and intended additional diagnostics. Changes in management after PET/CT were recorded. Patient outcome of different cohorts was analyzed for overall survival drawn from patient records. RESULTS: One hundred fifty-five patients (53 female; 63.4 ± 12.1 years) were included. Intended therapeutic management was revised in 45.8% of patients after PET/CT, including major changes affecting the intended treatment goal in 26.5% of patients and minor changes (therapy adjustments) in 19.3% of patients. Invasive and additional diagnostic procedures were intended in 25.8% and 63.2% prior PET/CT and 13.5% and 6.5% after PET/CT. PET/CT-based curative therapy concepts were associated with significantly longer patient survival (4.7 ± 0.3 years) than palliative therapy concepts (1.8 ± 0.5 years, p = .0001). Patients with cervical CUP showed a significantly longer survival (4.3 ± 0.3 years) than patients with extracervical CUP (3.5 ± 0.5 years, p = .01). The identification of the primary did not significantly affect survival. CONCLUSION: This registry study confirms previous studies reporting that PET/CT significantly influences clinical management in patients with CUP, helping physicians to select a more individualized treatment and to avoid additional diagnostics. Furthermore, we could confirm that tumor localization and extent as shown by PET/CT have a significant impact on patient prognosis. KEY POINTS: • PET/CT significantly influences intended clinical management in patients with CUP, helping physicians to select a more individualized treatment and to avoid additional diagnostics. • Tumor localization and extent as shown by PET/CT have a significant impact on patient prognosis. • The identification of the primary tumor has no significant impact on overall patient survival.
Authors: Yat-Yin Yau; Wing-Sze Chan; Yat-Man Tam; Phil Vernon; So Wong; Marc Coel; Simon Kwok-Fai Chu Journal: J Nucl Med Date: 2005-02 Impact factor: 10.057
Authors: Remco de Bree; Lisa van der Putten; Harm van Tinteren; Jan Wedman; Wim J G Oyen; Luuk M Janssen; Michiel W M van den Brekel; Emile F I Comans; Jan Pruim; Robert P Takes; Monique G G Hobbelink; Renato Valdés Olmos; Bernard F A M van der Laan; Maarten Boers; Otto S Hoekstra; C René Leemans Journal: Radiother Oncol Date: 2015-10-20 Impact factor: 6.280
Authors: Niklas Breuer; Florian F Behrendt; Alexander Heinzel; Felix M Mottaghy; Moritz Palmowski; Frederik A Verburg Journal: Clin Nucl Med Date: 2014-02 Impact factor: 7.794
Authors: Ronald Boellaard; Roberto Delgado-Bolton; Wim J G Oyen; Francesco Giammarile; Klaus Tatsch; Wolfgang Eschner; Fred J Verzijlbergen; Sally F Barrington; Lucy C Pike; Wolfgang A Weber; Sigrid Stroobants; Dominique Delbeke; Kevin J Donohoe; Scott Holbrook; Michael M Graham; Giorgio Testanera; Otto S Hoekstra; Josee Zijlstra; Eric Visser; Corneline J Hoekstra; Jan Pruim; Antoon Willemsen; Bertjan Arends; Jörg Kotzerke; Andreas Bockisch; Thomas Beyer; Arturo Chiti; Bernd J Krause Journal: Eur J Nucl Med Mol Imaging Date: 2014-12-02 Impact factor: 9.236
Authors: G Huebner; H Link; C H Kohne; M Stahl; A Kretzschmar; S Steinbach; G Folprecht; H Bernhard; S E Al-Batran; P Schoffski; C Burkart; F Kullmann; B Otremba; M Menges; M Hoffmann; U Kaiser; A Aldaoud; A Jahn Journal: Br J Cancer Date: 2008-12-09 Impact factor: 7.640
Authors: Sungmin Woo; Anton S Becker; Richard K G Do; Heiko Schöder; Hedvig Hricak; H Alberto Vargas Journal: Eur J Cancer Date: 2021-11-02 Impact factor: 9.162