Is important to avoid aggressive treatments in P with OMD with undetected metastasis. Previous data demonstrated that PET can have a significant clinical impact, especially in colorectal cancer.
Retrospectively, we review the history of P studied with PET at our unit, from October 2013 to December 2017. We included only P with OMD with a PET done to complete disease extension study in addition to conventional imaging and previously to undergo a potential curative management. Baseline data (age, sex, primary and stage), disease extension and initial strategy before PET were collected. After PET, disease extension, definitive strategy and overall survival (OS) was determined.
Overall, 93 P met the inclusion criteria: 72 (77%) colorectal (CRC), 13 (14%) melanoma, 4 (4%) biliary tract, 2 (2%) oesophageal and 2 (2%) other primaries. The mean age was 64 years (range: 24-83) and 58 (62%) P were male. At debut, 64 (79%) P were non-metastatic, and PET was done at the recurrence. After PET, 47 (51%) P were restaged: 35 (38%) were upstaged and 12 (13%) were downstaged. Final strategy was changed in 43 (46%) P, leading to a non-radical plan in 32 (34%) P. On the radical plan group there was 2 (2.2%) p with no malignant disease after surgery (pulmonary tuberculosis and aspergillosis). Median OS after PET in CRC cohort with changed strategy was significantly lower (28m, CI 95% 23-32) versus cohort without changes (47m, CI 95% 29-65); p-value 0.03.
After PET approximately half of P were restaged, consequently avoiding aggressive strategies in one-third of P. PET seems to be effective in selecting P with poor overall survival outcomes that need a palliative rather than a radical management. PET has relevant advantages compared with conventional imaging in the selection of P with OMD disease who may be eligible for surgery or local techniques.
Clinical trial identification
Legal entity responsible for the study
Catalan Institute of Oncology (ICO Badalona).
Has not received any funding.
All authors have declared no conflicts of interest.