CT-PET scans spot occult esophageal cancer metastasis
NEW YORK (Reuters Health) - Computed tomography with positron emission tomography (CT-PET) performed after neoadjuvant therapy in patients with potentially resectable esophageal carcinoma, is an important method for detecting distant metastases that preclude resection, Texas-based researchers report.
As lead investigator Dr. John Bruzzi told Reuters Health, "It has been our experience that, both during and after the completion of induction chemoradiotherapy for esophageal cancer, CT-PET scanning can diagnose new metastatic disease that would not be detected by standard investigations."
In the January issue of Cancer, Dr. Bruzzi and colleagues at M. D. Anderson Cancer Center, Houston report on their retrospective study of 86 patients with potentially resectable esophageal carcinoma who received neoadjuvant therapy before planned surgical resection.
CT-PET was conducted before and after completion of neoadjuvant therapy as a possible means of evaluating therapeutic response.
The team found that the approach was of limited utility in such assessment. It was unable in predict pathological response in the primary tumor or locoregional lymph nodes. However, CT-PET did identify the appearance of unexpected metastatic disease in 8% of the patients.
"In any patient with esophageal cancer who is being considered for surgery after chemoradiotherapy, CT-PET should be performed to exclude occult metastases," Dr. Bruzzi advised.
"For this reason," he concluded, "CT-PET has become a part of the routine clinical care of patients with esophageal cancer in our institution."
Cancer 2007;109:125-134.