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Title: Does 18 FDG PET CT predict complete pathological response to neoadjuvant chemoradiotherapy in locally advanced rectal cancer?
Epworth Authors: Ryan, Jennifer
Warrier, Satish
Lynch, A. Craig
Heriot, Alexander
Keywords: Chemoradiotherapy, Adjuvant
Rectal Cancer
Positron-Emission Tomography
X-Ray Micro-CT Scans
Fluorodeoxyglucose F18
Rectal Neoplasms
Cancer of the Rectum
Rectal Cancer
Rectal Tumors
Tumors or Cancer of the Rectum
Cancer Services Clinical Institute, Epworth HealthCare, Victoria, Australia
Issue Date: Jul-2014
Conference Name: Tripartite Colorectal Meeting of the American Society of Colon and Rectal Surgeons, ASCRS; Association of Coloproctology of GB and Ireland; the Section of Coloproctology, Royal Society of Medicine; the Colon and Rectal Surgery Section.
Conference Location: Birmingham, United Kingdom
Abstract: Aim: Pathological complete response (pCR) of rectal cancer to neoadjuvant chemoradiotherapy (nCRT) confers a survival advantage and the potential to avoid surgery in selected cases. The aim was to assess the role of 18 FGD PET CT in the identification of pCR. Method: Patients with advanced rectal cancer (including 26 patients with stage IV disease) undergoing nCRT and surgery at a tertiary centre were identified from a prospective database. All patients underwent 18 FDG PET CT scans prior to and after nCRT and metabolic response [complete (CMR), partial (PMR)] was assessed. Complete pathological response (pCR) was assessed on the resected specimen. Results: Pathological complete response was identified in 34 out of 195 patients (138M, 57F) Cancer specific survival was 86.7% with a local recurrence (LR) rate of 6.15%. 64 (32.8%) patients had a CMR on PET. The accuracy, sensitivity, and specificity of PET CT to predict pCR was: 70%, 59%, and 73% respectively. Both pCR and CMR identified patient groups with superior prognosis. 5 years survival was 97% for pCR, and 87.5% in CMR. No patient with pCR had a LR compared with 1.5%in MCR and 8.2% for those with a PMR. All 20 patients with both a pCR and CMR had 100% cancer specific survival. Conclusion: FDG PET CT has moderate accuracy in identification of pCR, however CMR identifies patients with low risk of local recurrence and 100% cancer specific survival when combined with pCR.
Type: Conference Paper
Affiliated Organisations: Division of Cancer, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
Department of Molecular Imaging, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
Type of Clinical Study or Trial: Reviews/Systematic Reviews
Appears in Collections:Cancer Services

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