Help
Subscribe


GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy

 29 August 2016

Advanced search
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy 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

 29 August 2016 
Reducing Hep B-related HCC
 29 August 2016 
Hep B immunization of infants for liver cancer
 29 August 2016 
Risk factor for post-ERCP pancreatitis
 26 August 2016 
Reasons for premature surveillance colonoscopy
 26 August 2016 
Celiac disease therapeutics
 26 August 2016 
Bleeding after endoscopic dissection-induced gastric ulcers
 25 August 2016 
Short-chain fatty acids in mixed refractory constipation
 25 August 2016 
Post-infectious IBS in C. diff
 25 August 2016 
Stool DNA test for colorectal cancer screening
 24 August 2016 
Genetics and therapy response in IBD
 24 August 2016 
Hep B after infant vaccination program
 24 August 2016 
Obeticholic acid for primary biliary cholangitis
 23 August 2016 
Colorectal cancer genetics as biomarkers
 23 August 2016 
Prognostic test for mortality after liver transplant
 23 August 2016 
Postoperative mortality in elderly with IBD
 22 August 2016 
Celiac disease in the elderly
 22 August 2016 
Laparoscopic vs open colectomy databases
 22 August 2016 
Mucosal healing and ulcerative colitis outcomes
 19 August 2016 
Dietary questionnaire for GI clinics
 19 August 2016 
Botox treatment for chronic anal fissure
 19 August 2016 
Myeloid-derived suppressor cells in GI cancers
 18 August 2016 
Gallstone formation determinants
 18 August 2016 
Age disparities in IBD therapy
 18 August 2016 
Seasonal variation in diverticulitis
 17 August 2016 
IBD activity score for routine clinical use
 17 August 2016 
Attitudes to H. pylori in primary care
 17 August 2016 
Nonselective β-blockers and mortality in cirrhosis
 16 August 2016 
Upper GI lesions in adults with IBD
 16 August 2016 
C. difficile infection and mortality when managed by GI surgeons
 16 August 2016 
HCV eradication in cirrhosis
 15 August 2016 
Predicting favorable outcomes in IBD
 15 August 2016 
Scoring system predicted microscopic colitis
 15 August 2016 
Mortality in spontaneous bacterial peritonitis
 12 August 2016 
Recurrence of resected gastric cancer
 12 August 2016 
Screening for pancreatic cancer
 12 August 2016 
Index for diagnostic accuracy of Crohn's
 11 August 2016 
Colorectal neoplasm on surveillance colonoscopies
 11 August 2016 
Bowel disease in primary care patients with bowel symptoms
 11 August 2016 
Diagnosis in covert hepatic encephalopathy
 10 August 2016 
Maintenance therapy for children with eosinophilic esophagitis
 10 August 2016 
Moderate alcohol use and insulin action in HCV
 10 August 2016 
Consensus on the management of GERD
 09 August 2016 
Pancreatitis quality of life instrument
 09 August 2016 
Gallstone disease and NAFLD
 09 August 2016 
Steroid dependency and IBD
 08 August 2016 
Venous thromboembolism in celiac disease
 08 August 2016 
C. diff in IBD 
 08 August 2016 
Gut-directed hypnotherapy vs low FODMAP diet in IBS
 05 August 2016 
Therapy for H.pylori treatment
 05 August 2016 
Obesity and the development of NAFLD
 05 August 2016 
Obesity and CVD in celiac disease
 04 August 2016 
Bleeding after endoscopic resection of colorectal lesions
 04 August 2016 
Novel risk factor for post-ERCP pancreatitis
 04 August 2016 
Ondansetron for children with acute gastroenteritis
 03 August 2016 
Post-colonoscopy complications
 03 August 2016 
IVF in women with IBD
 03 August 2016 
Post-operative pancreatic fistulae after pancreatic surgery
 02 August 2016 
H. pylori in children
 02 August 2016 
Gastric cancer in patients with gastric intestinal metaplasia
 02 August 2016 
Behavioral changes and bariatric surgery

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2016 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us