Help
Subscribe


All of GastroHep is now free access! - Click here to register Read For FREE - Our full range of review articles
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Guido Tytgat Profile of Pete Peterson Profile of Peter Cotton Profile of Roy Pounder

Home

News  
Journals
Review Articles
Slide Atlas
Video Clips
Online Books
Advanced Digestive Endoscopy
Classical Cases
Conference Diary
PubMed
International GH Links
USA GH Links
National GH Links
National GI Societies
Other Useful Links




Emails on Gastroenterology and Hepatology
the National AIDS Treatment Advocacy Project
Visit the gastroenterology section of the EUMS

News

Value of PET before liver surgery for colorectal cancer metasases is queried

A study in this week's issue of the Journal of the American Medical Association examines the effect of PET before liver resection on the surgical management of colorectal adenocarcinoma metastases.

News image

Patients with colorectal cancer with liver metastases undergo hepatic resection with curative intent.

Positron emission tomography combined with computed tomography (PET-CT) could help avoid noncurative surgery by identifying patients with occult metastases.

Dr Carol-Anne Moulton and colleagues from Canada determined the effect of preoperative PET-CT vs no PET-CT (control) on the surgical management of patients with resectable metastases.

The team investigated the effect of PET-CT on survival and the association between the standardized uptake value, and survival.

The team conducted a randomized trial of patients older than 18 years with colorectal cancer treated by surgery, with resectable metastases based on CT scans of the chest, abdomen, and pelvis within the previous 30 days, and with a clear colonoscopy within the previous 18 months between 2005 and 2013.

The trial involved 21 surgeons at 9 hospitals in Ontario, Canada, with PET-CT scanners at 5 academic institutions.
Liver resection was performed in 91% of patients in the PET-CT group
Journal of the American Medical Association

Patients were randomized using a 2 to 1 ratio to PET-CT or control.

The researchers' primary outcome was a change in surgical management defined as canceled hepatic surgery, more extensive hepatic surgery, or additional organ surgery based on the PET-CT.

Survival was a secondary outcome.

Of the 263 patients who underwent PET-CT, the team noted that 21 had a change in surgical management.

Specifically, 3% of patients did not undergo laparotomy, 2% had more extensive hepatic surgery, 3% had additional organ surgery, and the abdominal cavity was opened in 1 patient but hepatic surgery was not performed, and the cavity was closed.

The team observed that liver resection was performed in 91% of patients in the PET-CT group, and 92% of the control group.

After a median follow-up of 36 months, the estimated mortality rate was 11 events per 1000 person-months for the PET-CT group, and 13 events per 1000 person-months for the control group.

The team noted that survival did not differ between the 2 groups.

The researchers found that standardized uptake value was associated with survival.

The C statistic for the model including the standardized uptake value was 0.62, and without it was 0.50.

The difference in C statistics is 0.12.

The team report that a low C statistic suggests that the standard uptake value is not a strong predictor of overall survival.

Dr Moulton's team concludes, "Among patients with potentially resectable hepatic metastases of colorectal adenocarcinoma, the use of PET-CT compared with CT alone did not result in frequent change in surgical management."

"These findings raise questions about the value of PET-CT scans in this setting."

JAMA 2014; 311(18): 1863-1869
16 May 2014

Go to top of page Email this page Email this page to a colleague

 01 September 2015

Advanced search
 01 September 2015 
Nonceliac wheat sensitivity and autoimmune disease
 01 September 2015 
Dysphagia after antireflux surgery
 01 September 2015 
Predict treatment success in ulcerative colitis
 31 August 2015 
Cancer incidence in Barrett's
 31 August 2015 

Fecal microbiota transplantation in IBD

 31 August 2015 
Probiotics and liver transplantation
 28 August 2015 
Statin use and survival in pancreatic cancer
 28 August 2015 
Bacterial endotoxin and NAFLD
 28 August 2015 
Interferon-free regimens for Hep C
 27 August 2015 
HCV in Egypt
 27 August 2015 
Gene expression for hepatocellular carcinoma
 27 August 2015 
Liver abnormalities in celiac disease
 26 August 2015 
Medical management of diverticular disease
 26 August 2015 
Treatment of erosive esophagitis
 26 August 2015 
Dermatological complications of anti-TNF therapy in IBD
 25 August 2015 
Markers for colorectal cancer screening
 25 August 2015 
Long-term PPI use and serum gastrin levels
 25 August 2015 
Treatment for HCV and HIV-1 co-infection
 24 August 2015 
Treatment for HCV and HIV-1 co-infection
 24 August 2015 
Cirrhosis in Hepatitis C patients
 24 August 2015 
Aspirin use and colorectal cancer survival
 21 August 2015 
Activity indexes in ulcerative colitis
 21 August 2015 
Coffee and gallstone disease
 21 August 2015 
Alcoholic cirrhosis in relapse after liver transplant
 20 August 2015 
Cirrhosis in the USA
 20 August 2015 
Mortality causes in liver cirrhosis
 20 August 2015 
Risk of death in IBD
 19 August 2015 
Predicting intestinal surgery in Crohn's disease
 19 August 2015 
Sleep positioning device reduces reflux
 19 August 2015 
Improved screening colonoscopy quality
 18 August 2015 
Health insurance influences HCV screening outcomes
 18 August 2015 
Somatostatin analogues in polycystic liver disease
 18 August 2015 
Global consensus report on H. pylori gastritis
 17 August 2015 
Biomarker of fibrosis stage in NAFLD
 17 August 2015 
Prognostic score for primary biliary cirrhosis
 17 August 2015 
Measuring subjective health in patients with IBS
 14 August 2015 
Factors that influence ulcerative colitis procedure type
 14 August 2015 
H. pylori in African American and Hispanic veterans
 14 August 2015 
Hep E virus in decompensated chronic liver disease
 13 August 2015 
H. pylori in drinking water
 13 August 2015 
Sofosbuvir-regimens in HCV
 13 August 2015 
IBS among Japanese adolescents
 12 August 2015 
Infliximab in patients in IBD
 12 August 2015 
Predictors of severity of IBD
 12 August 2015 
Peritoneal carcinomatosis in colorectal cancer
 11 August 2015 
Chemotherapy and intestinal microbiomes
 11 August 2015 
H. pylori and immune thrombocytopenic purpura
 11 August 2015 
Sexual dysfunction after rectal cancer treatment
 10 August 2015 
Predicting lymph node metastasis in T1 colorectal cancer
 10 August 2015 
Scoring systems to predict alcoholic hepatitis outcomes
 10 August 2015 
Sofosbuvir-based regimens in veterans with HCV
 07 August 2015 
Factors associated with changes in ulcerative colitis
 07 August 2015 
Bariatric surgery and NASH in obese patients
 07 August 2015 
Caffeine and fibrosis in Hep C
 06 August 2015 
Disparities in colonoscopic examination
 06 August 2015 
Weight loss and NASH
 06 August 2015 
Diagnosis of IBS
 05 August 2015 
Gender differences in fecal immunochemical tests
 05 August 2015 
Adenoma detection rates with a screening colonoscopy program
 05 August 2015 
Extraintestinal manifestations in IBD diagnosis

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2015 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us