PET-CT Rarely Impacts Surgical Management of CRC Metastases
(HealthDay News) — The use of positron emission tomography combined with computed tomography (PET-CT) compared with CT rarely impacts surgical management for patients with potentially resectable hepatic metastases of colorectal adenocarcinoma, according to a study published in the May 14 issue of the Journal of the American Medical Association.
Carol-Anne Moulton, MB, BS, from the University Health Network in Toronto, and colleagues examined the effect of preoperative PET-CT versus no PET-CT (control) on the surgical management of patients with resectable metastases. Participants included patients older than 18 years with colorectal cancer treated by surgery and with resectable metastases based on CT scans within the previous 30 days. Participants were randomly allocated to PET-CT or control in a 2:1 ratio.
The researchers found that 8.0% of the 263 patients who underwent PET-CT had a change in surgical management. Liver resection was performed in 91 and 92% of the PET-CT and control groups, respectively. The estimated mortality rates were 11.13 and 12.71 events per 1,000 person-months for the PET-CT and control groups, respectively, with no significant difference in survival (hazard ratio, 0.86; P=0.38). There was a correlation between standardized uptake value and survival (hazard ratio, 1.11 per unit increase; P<0.001), with a C-statistic of 0.62 for the model including standardized uptake value.
"These findings raise questions about the value of PET-CT scans in this setting," the authors write.