PET/CT could help restage locally advanced rectal cancer

  • Sorenson E & al.
  • J Surg Res
  • 20 Jun 2019

  • curated by Jim Kling
  • Univadis Clinical Summaries
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Takeaway

  • Positron emission tomography-CT (PET-CT) imaging could identify patients with locally advanced rectal cancer who likely did not reach pathologic complete response (pCR) and should be considered for surgical management.

Why this matters

  • Patients with a postchemoradiation PET-CT maximal standardized uptake value (SUVmax) >4.3 are unlikely to have achieved pCR and should be considered for operative management.

Study design

  • Retrospective analysis of 125 patients at a single center.
  • Funding: None.

Key results

  • Patients with pCR had lower post-CRT SUVmax (3.2 vs 5.2 [P=.0009]; 72% decrease vs 58% [P=.0035]).
  • Post-CRT SUVmax max percentage decrease of more than 66% predicted pCR (sensitivity, 65%; specificity, 72%; positive predictive value [PPV], 44%; negative predictive value [NPV], 86%).
  • Combined SUVmax decrease of >66% and post-CRT SUVmax
  • pCR was associated with a median recurrence-free survival (RFS) of 81% vs 55% (P=.04), but no significant difference in 5-year OS (82% vs 65%; P=.085).
  • Post-CRT SUVmax

Limitations

  • Retrospective analysis, single center.

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