Assessing the impact of FDG-PET in the management of anal cancer

Nguyen, Brandon; Joon, Daryl Lim; Khoo, Vincent; Quong, George; Chao, Michael; Wada, M.; Joon, Michael Lim; See, Andrew; Feigen, M.; Rykers, Kym; Kai, C.; Zupan, E.; Scott, Andrew

doi:10.1016/j.radonc.2008.04.003

Cited by 106 publications

(63 citation statements)

References 39 publications

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“…The use of PET to stage anal cancer is increasing as a result of several studies (6)(7)(8)(9). There are few reports, however, regarding the utility of PET as a prognostic marker in patients with anal cancer.…”

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confidence: 99%

Metabolic Tumor Volume Predicts Disease Progression and Survival in Patients with Squamous Cell Carcinoma of the Anal Canal

et al. 2012

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PET imaging has become a useful diagnostic tool in patients with anal cancer. We evaluated the prognostic value of metabolic tumor volume (MTV) in patients with anal cancer treated with definitive chemoradiotherapy. Methods: Patients with anal cancer who underwent PET imaging for pretreatment staging or radiation therapy planning from 2003 to 2011 were included. PET parameters included MTV and maximum standardized uptake value (SUVmax). Total MTV (MTV-T) was defined as the sum of the volumes above a standardized uptake value 50% of the SUVmax within the primary tumor and involved nodes. KaplanMeier and Cox regression models were used to test for associations between metabolic or clinical endpoints and overall survival (OS), progression-free survival (PFS), and event-free survival (EFS). Results: Thirty-nine patients were included. Median follow-up for the cohort was 22 mo. Overall, 6 patients died and 9 patients had disease progression. The 2-y OS, PFS, and EFS for the entire cohort were 88%, 74%, and 69%, respectively. Higher MTV-T was associated with worse OS (P 5 0.04), PFS (P 5 0.004), and EFS (P 5 0.002) on univariate analysis. Patients with an MTV greater than 26 cm 3 had worse PFS than did those with an MTV of 26 cm 3 or less (33% vs. 82%, P 5 0.003). SUVmax was not prognostic for any outcome. Higher T classification (T3/T4 vs. T1/T2) was associated with worse PFS and EFS. When adjusting for T classification, MTV-T remained a significant predictor for PFS (P 5 0.01) and EFS (P 5 0.02). Conclusion: MTV-T yields prognostic information on PFS and EFS beyond that of established prognostic factors in patients with anal cancer.

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confidence: 99%

Metabolic Tumor Volume Predicts Disease Progression and Survival in Patients with Squamous Cell Carcinoma of the Anal Canal

et al. 2012

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“…Similar to its use in rectal cancer, FDG PET/CT may be considered as an adjunct to contrast-enhanced CT in patients with T2-T4 N0 disease, or any T-stage N-positive disease (4). Results of several studies (49)(50)(51)(52)(53) have shown increased sensitivity of FDG PET/CT compared with contrastenhanced CT alone for detection of abnormal lymph nodes, especially for advanced T2 tumors. This ultimately may lead to a change in treatment intent or altered radiation treatment fields (53).…”

Section: Anal Cancermentioning

confidence: 99%

“…This ultimately may lead to a change in treatment intent or altered radiation treatment fields (53). These studies remain limited because histologic confirmation of FDG-avid nodes is not part of the standard of care for anal cancer, leaving ambiguity about the distinction between tumor involvement and reactive changes in these nodes (52). Further research is needed to validate the use of FDG PET in patients with anal cancer.…”

Section: Anal Cancermentioning

confidence: 99%

Anorectal Cancer: Critical Anatomic and Staging Distinctions That Affect Use of Radiation Therapy

Matalon¹,

Mamon²,

Fuchs³

et al. 2015

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“…PET/CT proved useful in initial staging perirectal/pelvic or inguinal lymph nodes, causing a change in radiation fields in 16-35 % of patients [25][26][27][28][29]. However, upstaging related to lymph node metastases might have been overestimated, as up to 31 % of inguinal metastases identified by PET/CT are reportedly false positives [30].…”

Section: Diagnosismentioning

confidence: 99%

The treatment of squamous anal carcinoma: guidelines of the Italian society of colo-rectal surgery

2012

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The Italian society of colo-rectal surgery (SICCR) is dedicated to improving the study, prevention and management of the diseases of the colon, rectum and anus. One of the aims of the society is to establish guidelines to the treatment of these diseases. These guidelines are based on the international literature and on the best available evidence. Clinical practice guidelines are one of the most important instruments to provide therapeutic decision-making support, based on the best scientific evidence available at the time. Guidelines are advisory and not prescriptive, susceptible to continual variations secondary to innovations and new scientific evidence. These guidelines are a guide for all colo-rectal surgeons and physicians who approach anal cancer.

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Assessing the impact of FDG-PET in the management of anal cancer

Cited by 106 publications

References 39 publications

Metabolic Tumor Volume Predicts Disease Progression and Survival in Patients with Squamous Cell Carcinoma of the Anal Canal

Metabolic Tumor Volume Predicts Disease Progression and Survival in Patients with Squamous Cell Carcinoma of the Anal Canal

Anorectal Cancer: Critical Anatomic and Staging Distinctions That Affect Use of Radiation Therapy

The treatment of squamous anal carcinoma: guidelines of the Italian society of colo-rectal surgery

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