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Positron emission tomography changes management and prognostic stratification in patients with oesophageal cancer: results of a multicentre prospective study

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

Abstract

Objectives

The aims of this study were (1) to determine the incremental information provided by 18F-FDG positron emission tomography (PET) in staging patients with oesophageal cancer, and (2) to determine the impact of PET staging on post-PET clinical management of oesophageal cancer, and on prognosis.

Methods

In a multicentre, single-arm open study, patients with proved oesophageal cancer without definite distant metastases and regarded as suitable for potentially curative treatment were examined by PET. Clinicians were requested to supply a management plan before and another plan after being supplied with the PET scan results. Patients were followed for at least 1 year for outcome analysis.

Results

A total of 129 patients (104 men, mean age 67 y) were recruited. PET detected additional sites of disease in 53 patients (41%). Significant changes in management (high or medium impact) were observed in 38% of patients, primarily as a result of identifying additional sites of disease and/or confirming previously equivocal regional and distant metastases. Progression-free survival was significantly shorter in patients found to have additional lesions on PET (p < 0.05), but was not related to SUVmax.

Conclusion

These findings demonstrate the significant impact of PET on the clinical management of patients with newly diagnosed oesophageal carcinoma, and on prognostic stratification of these patients.

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Acknowledgements

The authors wish to acknowledge the Australian Government Department of Health and Ageing for funding, and the Australian and New Zealand Association of Physicians in Nuclear Medicine for managing the PET data collection project; Terri Davies, Andrew Chicco, Anh Le, Margot Yeomans, Kerryn Butler-Henderson and Debbie Lennon for their contribution to data collection; and the staff of the PET centres involved in the study.

Conflicts of Interest

None.

Author information

Authors and Affiliations

  1. Department of Nuclear Medicine and PET, Royal Adelaide Hospital, North Terrace, Adelaide, SA, 5000, Australia

    B. E. Chatterton

  2. Department of Nuclear Medicine and PET, Liverpool Hospital, Sydney, Australia

    I. Ho Shon

  3. MIA at Monash Medical Centre, Melbourne, Australia

    A. Baldey

  4. WA PET/Cyclotron Service, Sir Charles Gairdner Hospital, Perth, Australia

    N. Lenzo & A. Patrikeos

  5. Southern X-Ray Clinics, The Wesley Hospital, Brisbane, Australia

    B. Kelley & D. Wong

  6. Australian and New Zealand Association of Physicians in Nuclear Medicine, Melbourne, Australia

    J. E. Ramshaw

  7. Centre for PET, and Ludwig Institute for Cancer Research, Austin Hospital, Melbourne, Australia

    A. M. Scott

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  1. B. E. Chatterton
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  2. I. Ho Shon
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  4. N. Lenzo
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  6. B. Kelley
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Correspondence to B. E. Chatterton.

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Chatterton, B.E., Ho Shon, I., Baldey, A. et al. Positron emission tomography changes management and prognostic stratification in patients with oesophageal cancer: results of a multicentre prospective study. Eur J Nucl Med Mol Imaging 36, 354–361 (2009). https://doi.org/10.1007/s00259-008-0959-y

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  • DOI: https://doi.org/10.1007/s00259-008-0959-y

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