488P - Early postoperative PET-CT in patients with pathological stage III colon cancer may change their outcome: results from a large single institution s...

Date 09 September 2017
Event ESMO 2017 Congress
Session Poster display session
Topics Colon Cancer
Gastrointestinal Cancers
Imaging, Diagnosis and Staging
Presenter Assaf Moore
Citation Annals of Oncology (2017) 28 (suppl_5): v158-v208. 10.1093/annonc/mdx393
Authors A. Moore1, I. Ben-Aharon1, O. Purim1, G. Perl1, O. Ulitsky1, L. Amit1, Y. Kundel1, R. Lewin1, N. Wasserberg2, H. Kashtan2, B. Brenner1
  • 1Oncology, Rabin Medical Center, 49100 - petach tikva/IL
  • 2Surgery, Rabin Medical Center, 49100 - petach tikva/IL

Abstract

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.

Clinical trial identification

n/a

Legal entity responsible for the study

Davidoff Cancer Center, Rabin Medical Center

Funding

None

Disclosure

All authors have declared no conflicts of interest.