The role of early postoperative PET-CT in patients with pathological stage III colon cancer: Results from a large single institution study.

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 562-562
Author(s):  
Assaf Moore ◽  
Irit Ben-Aharon ◽  
Ofer Purim ◽  
Gali Perl ◽  
Olga Ulitsky ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Lymph Nodes ◽  
Metastatic Disease ◽  
Stage Iii ◽  
Individual Risk ◽  
Pathological Stage ◽  
Stage Iii Colon Cancer ◽  
Pet Ct

562 Background: Current staging of patients (pts) with pathological stage III colon cancer is suboptimal; many pts still recur despite unremarkable preoperative staging work-up. We previously reported that early postoperative PET-CT can alter the stage and management of pts with high risk stage III colon cancer in up to 19% of patients. The aim of the current study was to expand the previous one to a larger cohort and to determine the role of early postoperative PET-CT in the general population of stage III colon cancer pts, regardless of their individual risk. Methods: A retrospective chart review of all consecutive pts with stage III colon cancer who underwent early postoperative PET-CT between 2007 and 2016. Demographic and clinicopathological data were collected. Results: 247 pts, 124 (50%) males, with a median age of 66 years (range, 30-92), were included. Pathological stage was IIIA, IIIB and IIIC in 18 (7.3%), 161 (65.1%) and 72 (29.1%) pts, respectively. The median number of lymph nodes retrieved was 15 (range, 6-64) and that of positive lymph nodes was 2 (range, 0-21). High FDG-uptake was observed in 52 (21.0%) pts, including 6 (2.4%) who had clear postoperative changes, 10 (4.0%) who had a false positive abnormal uptake of whom 6 underwent invasive diagnostic procedures. The PET-CT results modified the management of 36 pts (14.5%) who were found to have true positive findings: 30 (12.1%) were proven to have overt metastatic disease and in 6 (2.4%) a second primary was discovered. With the median follow-up of 39.0 months (range 7.2-98.4 months), of the 30 pts found to be metastatic, 10 (33.3%) underwent curative treatments and are currently with no evidence of disease (NED). Updated data, on more patients and a longer follow-up, will be presented at the meeting. Conclusions: Early postoperative PET-CT changed the staging and treatment of 14.5% of resected stage III pts, and has the potential for early detection of curable metastatic disease. We currently evaluate this strategy and its actual impact in a prospective trial.

Early postoperative PET-CT in patients with pathological stage III colon cancer may change their outcome: Results from a large single-institution study.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e15163-e15163
Author(s):  
Assaf Moore ◽  
Irit Ben-Aharon ◽  
Ofer Purim ◽  
Gali Perl ◽  
Olga Ulitsky ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Preoperative Staging ◽  
Prospective Trial ◽  
Disease Free Survival ◽  
Stage Iii ◽  
Pathological Stage ◽  
Stage Iii Colon Cancer ◽  
Postoperative Changes ◽  
Pet Ct

e15163 Background: Staging of patients (pts) with pathological stage III colon cancer (CC) is currently suboptimal; many pts still recur despite an unremarkable preoperative staging. We previously reported that early postoperative PET-CT can alter the stage and management of up to 15% of pts with high risk stage III CC and later reported also encouraging preliminary results in a larger cohort of consecutive pts with stage III CC, in which staging and management were altered in 14.5%. The aim of the current study was to expand the previous one to a larger cohort and to evaluate the actual impact of early postoperative PET-CT on pts outcome. Methods: A Retrospective study of all consecutive pts with stage III CC who were treated at our institution and underwent early postoperative PET-CT between 2007-2016. Demographic and clinicopathological data were retrieved. Statistical analyses were done using standard methods. Results: 348 pts, 166 (47.7%) males, with a median age of 66 years (range, 29-92), were included. Pathological stage was IIIA, IIIB and IIIC in 21(6%), 254 (73%) and 73 (21%) pts, respectively. The median number of lymph nodes examined and of positive ones were 14 (range, 3-54) and 2 (range, 0-32), respectively. High FDG-uptake was noted in 95 (27.3%) pts, including 23 (6.6%) with clear postoperative changes and 18 (5.2%) with a false positive uptake, of whom 6 underwent invasive diagnostic procedures. PET-CT results modified the management of 52 pts (14.9%) who were found to have true positive findings: 44 (12.6%) with overt metastatic disease and 8 (2.3%) with a second primary tumor. At a median follow-up of 45.6 months, the estimated 5y disease-free survival for true stage III pts was 81.9% and the 6y overall survival of the entire cohort was 76.4%. Interestingly, of the 44 pts found to be metastatic, 12 (27.3%) underwent curative treatments and 8 (66.7%) of those remain free of disease, with a median follow-up of 64.7 months. Conclusions: In this large cohort, early postoperative PET-CT changed the staging and management of 14.9% of pts with resected stage III CC, with encouraging outcome results. We are conducting a prospective trial to further evaluate this strategy.

Postoperative PET-CT in patients (pts) with pathological stage III colon cancer (CC): Interim results from the first prospective validation study.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e15599-e15599
Author(s):  
Roi Tschernichovsky ◽  
Gali Perl ◽  
Inbar Finkel ◽  
Idit Peretz ◽  
Oded Jacobi ◽  
...  
Keyword(s):  
Metastatic Disease ◽  
Disease Free Survival ◽  
Stage Iii ◽  
Second Primary ◽  
Surgical Removal ◽  
Pathological Stage ◽  
Ct Findings ◽  
Pet Ct ◽  
The Impact

e15599 Background: A substantial number of pts with pathological stage III CC recur despite the absence of metastatic disease on pre-operative CT. In a previous large retrospective study from our institution on 348 pts, we reported that early postoperative PET-CT modified the staging and management of 13.4% of assumed stage III CC pts. The aim of the current study was to prospectively validate these results. Methods: A prospective, single-center study of pts with pathological stage III CC who underwent early postoperative PET-CT between the years 2013-2021. Results: 83 pts were accrued and 81 (48.1% males, median age 66y) were evaluable for the primary endpoint i.e. PET-CT results. Pathological stage was IIIA, IIIB and IIIC in 7 (8.6%), 56 (69.1%) and 17 (21%) of pts, respectively. Median number of lymph nodes examined and of positive nodes were 17 (range, 9-134) and 2 (range, 0-15), respectively. Post-operative PET-CT findings were significant in 7 pts (8.6%): 4 pts (4.9%) were upstaged to stage IV, 2 (2.5%) were diagnosed with a second primary malignancy, and 1 (1.2%) was both upstaged and diagnosed with another cancer. Three additional pts (3.7%) are currently undergoing evaluation for suspicious PET-CT findings. At a median follow-up of 30.6 months (range, 6.2-92), 13 of the 71 pts with true stage III CC recurred; the estimated 3y disease-free survival rate was 81%. The estimated 5y overall survival rates for the entire cohort and for true stage III pts were 82% and 90%, respectively. Of the 5 pts found to have metastatic disease based on PET-CT findings, one is scheduled to undergo potentially curative surgical removal of a solitary liver metastasis. Conclusions: Interim results from the first prospective study to evaluate the impact of early postoperative PET-CT in pts with pathological stage III CC seem to support earlier retrospective data: the use of PET-CT in this setting changed the staging and management of 8.6% of pts, including the possibility for early detection of potentially curable metastatic disease. Additional data, with more pts and longer follow-up, will be presented at the meeting.

scholarly journals Early PET-CT in patients with pathological stage III colon cancer may improve their outcome: Results from a large retrospective study

2018 ◽  
Vol 7 (11) ◽  
pp. 5470-5477
Author(s):  
Assaf Moore ◽  
Olga Ulitsky ◽  
Irit Ben-Aharon ◽  
Gali Perl ◽  
Yulia Kundel ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Retrospective Study ◽  
Stage Iii ◽  
Pathological Stage ◽  
Stage Iii Colon Cancer ◽  
Pet Ct ◽  
Large Retrospective Study

The role of postoperative PET-CT in the evaluation of patients with high-risk stage III colon cancer (CC).

2010 ◽  
Vol 28 (15_suppl) ◽  
pp. e14089-e14089
Author(s):  
Y. Kundel ◽  
B. Brenner ◽  
Y. Asman ◽  
N. Vaserberg
Keyword(s):  
Colon Cancer ◽  
High Risk ◽  
Stage Iii ◽  
Stage Iii Colon Cancer ◽  
Pet Ct

scholarly journals A Lymph Node Ratio of 10% Is Predictive of Survival in Stage III Colon Cancer: A French Regional Study

2014 ◽  
Vol 99 (4) ◽  
pp. 344-353 ◽  
Author(s):  
Charles Sabbagh ◽  
François Mauvais ◽  
Cyril Cosse ◽  
Lionel Rebibo ◽  
Jean-Paul Joly ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Lymph Node ◽  
Prognostic Factor ◽  
Lymph Nodes ◽  
Lymph Node Ratio ◽  
Disease Free Survival ◽  
Stage Iii ◽  
Stage Iii Colon Cancer ◽  
Node Ratio

Abstract Lymph node ratio (LNR) (positive lymph nodes/sampled lymph nodes) is predictive of survival in colon cancer. The aim of the present study was to validate the LNR as a prognostic factor and to determine the optimum LNR cutoff for distinguishing between “good prognosis” and “poor prognosis” colon cancer patients. From January 2003 to December 2007, patients with TNM stage III colon cancer operated on with at least of 3 years of follow-up and not lost to follow-up were included in this retrospective study. The two primary endpoints were 3-year overall survival (OS) and disease-free survival (DFS) as a function of the LNR groups and the cutoff. One hundred seventy-eight patients were included. There was no correlation between the LNR group and 3-year OS (P = 0.06) and a significant correlation between the LNR group and 3-year DFS (P = 0.03). The optimal LNR cutoff of 10% was significantly correlated with 3-year OS (P = 0.02) and DFS (P = 0.02). The LNR was not an accurate prognostic factor when fewer than 12 lymph nodes were sampled. Clarification and simplification of the LNR classification are prerequisites for use of this system in randomized control trials. An LNR of 10% appears to be the optimal cutoff.

scholarly journals Early postoperative PET-CT in patients with pathological stage III colon cancer may change their outcome: Results from a large single institution study

2017 ◽  
Vol 28 ◽  
pp. v165
Author(s):  
A. Moore ◽  
I. Ben-Aharon ◽  
O. Purim ◽  
G. Perl ◽  
O. Ulitsky ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Stage Iii ◽  
Pathological Stage ◽  
Single Institution ◽  
Stage Iii Colon Cancer ◽  
Pet Ct

Should Total Number of Lymph Nodes be Used as a Quality of Care Measure for Stage III Colon Cancer?

2010 ◽  
Vol 251 (1) ◽  
pp. 184-185
Author(s):  
Jiping Wang ◽  
Mahmoud Kulaylat ◽  
James Hassett ◽  
Kelli Bullard Dunn ◽  
Merril Dayton ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Quality Of Care ◽  
Lymph Nodes ◽  
Stage Iii ◽  
Stage Iii Colon Cancer ◽  
Care Measure

scholarly journals Genetic and immunological biomarkers predict metastatic disease recurrence in stage III colon cancer

BMC Cancer ◽  
2018 ◽  
Vol 18 (1) ◽  
Author(s):  
Andreas Sperlich ◽  
Alexander Balmert ◽  
Dietrich Doll ◽  
Sabine Bauer ◽  
Fabian Franke ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Metastatic Disease ◽  
Disease Recurrence ◽  
Stage Iii ◽  
Stage Iii Colon Cancer
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