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[Follow-up after curative surgery for colorectal cancer: impact of positron emission tomography - computed tomography
Gustavo Kishimoto1, Koji Murakami, Sergio A Con
1Centro de PET, Universidad Médica de Dokkyo, Mibu, Japón.
Unlabelled:
Postoperative surveillance has an important role in patient survival after curative resection of colorectal cancer.
Objectives:
To describe the characteristics of the follow-up with positron emission tomography (PET) / computed tomography (CT)(PET/CT) and its impact in colorectal cancer (CRC) survivors after curative resection in a university hospital in Tochigi Prefecture, Japan.
Materials And Methods:
Consecutive review of patient's hospital charts who underwent presurgical staging with PET/CT for curative resection of colorectal cancer between April 2005 and March 2008. The follow-up data of these patients was reviewed until September 2008.
Results:
Of 209 patients presurgically staged for CRC, 207 (male/female = 125/82; mean age = 65.3 ± 11.3 years) underwent curative resection and were included in the present study. The compliance rate with the Japanese Society for Cancer of the Colon and Rectum (JSCCR) follow-up guidelines was 53%. The cumulative survival at the end of study interval was 96.4%. The test most commonly used in postoperative follow-up of CRC was the carcinoembryonic antigen (CEA). PET/CT was the test that detected more patients with recurrent lesions (n = 11, positive predictive value = 23.4), including one patient with an asymptomatic curable recurrence (inguinal lymph node metastasis), also being the most effective test (2.1%). However, its high cost makes it the less cost-effective.
Conclusions:
The use of PET/CT in the postoperative follow-up after curative resection in CRC has proven to be an individualized and effective alternative in the finding of asymptomatic disease curable. Systematic CEA tests with contrast-enhanced CT as a first line of screening and PET/CT as a second line may be an alternative follow up approach after curative resection for CRC.
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