Regular PET/CT imaging fails to extend high-risk CRC patient survival
medwireNews: Researchers do not recommend the addition of 18F-fluorodeoxyglucose–positron emission tomography/computed tomography (18F-FDG–PET/CT) to a standard 3-year monitoring strategy for patients with stage II perforated, stage III, or stage IV colorectal cancer (CRC) at high risk for recurrence.
As hypothesized, unresectable recurrence was detected significantly earlier in the 120 patients who underwent 18F-FDG–PET/CT imaging at 6-month intervals – in addition to 3-monthly physical examination and laboratory tests, plus 6-monthly liver ultrasound, chest radiography, and whole-body CT – compared with the 119 patients who received usual care alone, at 7.0 versus 14.3 months.
However, the primary endpoint of treatment failure did not significantly differ between the 18F-FDG–PET/CT imaging and control arms, at a rate of 29.2% versus 23.7%.
And 18F-FDG–PET/CT imaging was not associated with an improvement in overall or disease-free survival, say Iradj Sobhani, from Hôpital Henri Mondor in Créteil, France, and co-workers.
Furthermore, contrary to the working hypothesis that early detection would offset the additional expense of imaging, the intervention was associated with significantly higher costs than usual care, at a total of € 18,192 versus € 11,131 (US$ 22,341 vs 13,670) per patient.
“18FDG PET-CT is not advised routinely,” the researchers conclude in the Annals of Oncology, although they add that “in some selected patients such as those with tumour marker elevation but no other evidence of disease it might be useful.”
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