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Systematic Review of FDG-PET Prediction of Complete Pathological Response and Survival in Rectal Cancer

  • Colorectal Cancer
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Advances in the management of rectal cancer have resulted in an increased application of multimodal therapy with the aim of tailoring therapy to individual patients. Complete pathological response (pCR) is associated with improved survival and may be potentially managed without radical surgical resection. Over the last decade, there has been increasing interest in the ability of functional imaging to predict complete response to treatment. The aim of this review was to assess the role of 18F-flurordeoxyglucose positron emission tomography (FDG-PET) in prediction of pCR and prognosis in resectable locally advanced rectal cancer.

Methods

A search of the MEDLINE and Embase databases was conducted, and a systematic review of the literature investigating positron emission tomography (PET) in the prediction of pCR and survival in rectal cancer was performed.

Results

Seventeen series assessing PET prediction of pCR were included in the review. Seven series assessed postchemoradiation SUVmax, which was significantly different between response groups in all six studies that assessed this. Nine series assessed the response index (RI) for SUVmax, which was significantly different between response groups in seven series. Thirteen studies investigated PET response for prediction of survival. Metabolic complete response assessed by SUV2max or visual response and RISUVmax showed strong associations with disease-free survival (DFS) and overall survival (OS).

Conclusion

SUV2max and RISUVmax appear to be useful FDG-PET markers for prediction of pCR and these parameters also show strong associations with DFS and OS. FDG-PET may have a role in outcome prediction in patients with advanced rectal cancer.

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Disclosures

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Authors and Affiliations

  1. Department of Colorectal Surgery, Division of Cancer Surgery, Peter MacCallum Cancer Centre, East Melbourne, University of Melbourne, Parkville, Australia

    Sameer Memon FRACS, A. Craig Lynch MMedSci, FRACS, FCSSANZ, FASCRS (INT), Satish K. Warrier MS, FRACS & Alexander G. Heriot MD FRCS (Gen.), FRCSEd, FRACS

  2. Centre for Molecular Imaging, Peter MacCallum Cancer Centre, East Melbourne, University of Melbourne, Parkville, Australia

    Timothy Akhurst MD, MBBS

  3. Division of Radiation Oncology, Peter MacCallum Cancer Centre, East Melbourne, University of Melbourne, Parkville, Australia

    Samuel Y. Ngan MBBS

  4. Department of Cancer Medicine, Peter MacCallum Cancer Centre, East Melbourne, University of Melbourne, Parkville, Australia

    Michael Michael MD, FRACP

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  1. Sameer Memon FRACS
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  2. A. Craig Lynch MMedSci, FRACS, FCSSANZ, FASCRS (INT)
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  3. Timothy Akhurst MD, MBBS
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Correspondence to Alexander G. Heriot MD FRCS (Gen.), FRCSEd, FRACS.

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Memon, S., Lynch, A.C., Akhurst, T. et al. Systematic Review of FDG-PET Prediction of Complete Pathological Response and Survival in Rectal Cancer. Ann Surg Oncol 21, 3598–3607 (2014). https://doi.org/10.1245/s10434-014-3753-z

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  • DOI: https://doi.org/10.1245/s10434-014-3753-z

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