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Significant clinical impact and prognostic stratification provided by FDG-PET in the staging of oesophageal cancer

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

To evaluate the clinical impact of FDG-PET in staging oesophageal cancer and whether this information improves prognostic stratification.

Methods

Impact was based on comparison of a prospectively recorded pre-PET plan with post-PET treatment in 68 consecutive patients undergoing primary staging. Survival was analysed using the Kaplan-Meier product limit method and the Cox proportional hazards regression model.

Results

FDG-PET findings impacted on the management of 27/68 patients (40%): in 12 therapy was changed from curative to palliative and in three from palliative to curative, while in 12 other patients there was a change in the treatment modality or delivery but not in the treatment intent. The median survival was 21 months, with post-PET stage and treatment intent both strongly associated with survival (p<0.001). Conventional stage was not able to clearly stratify this population.

Conclusion

The use of FDG-PET for primary staging of oesophageal cancer changed the clinical management of more than one-third of patients and provided superior prognostic stratification compared with conventional investigations.

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Acknowledgements

The authors would like to thank Elizabeth Drummond and Annette Hogg for their tireless efforts in pursuing patients’ follow-up data and maintaining the PET database. Dr. Cuong Duong’s research endeavour has been supported by the Royal Australasian College of Surgeons and the National Health and Medical Research Council Postgraduate Medical Scholarship.

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Authors and Affiliations

  1. Division of Surgical Oncology, Peter MacCallum Cancer Centre, Melbourne, Vic., Australia

    Cuong P. Duong, Helen Demitriou, Anne Thompson, David Williams & Robert J. S. Thomas

  2. Statistical Center, Peter MacCallum Cancer Centre, Melbourne, Vic., Australia

    LeAnn Weih

  3. Centre for Molecular Imaging, Peter MacCallum Cancer Centre, Locked Bag 1 A’Beckett Street, 8006, Melbourne, Vic., Australia

    Rodney J. Hicks

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  1. Cuong P. Duong
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  2. Helen Demitriou
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Correspondence to Rodney J. Hicks.

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Duong, C.P., Demitriou, H., Weih, L. et al. Significant clinical impact and prognostic stratification provided by FDG-PET in the staging of oesophageal cancer. Eur J Nucl Med Mol Imaging 33, 759–769 (2006). https://doi.org/10.1007/s00259-005-0028-8

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  • DOI: https://doi.org/10.1007/s00259-005-0028-8

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