Impact of 18 FDG- PET CT in the Management of Muscle Invasive Bladder Cancer.

Autor: Bertolaso P; Department of Medical Oncology, University Hospital, Bordeaux, France. Electronic address: pauline.bertolaso@chu-bordeaux.fr., Brouste V; Clinical and Epidemiology Research Unit, Institut Bergonié, Comprehensive Cancer Centre, Bordeaux, France., Cazeau AL; Nuclear Medicine Department, Institut Bergonié, Comprehensive Cancer Centre, Bordeaux, France., de Clermont-Gallerande H; Nuclear Medicine Department, University Hospital of Bordeaux, Bordeaux, France; University of Bordeaux, Bordeaux, France., Bladou F; University of Bordeaux, Bordeaux, France; Department of Urology, University Hospital, Bordeaux, France., Cabart M; Department of Medical Oncology, Institut Bergonié, Comprehensive Cancer Centre, Bordeaux, France., Lefort F; Department of Medical Oncology, University Hospital, Bordeaux, France., Gross-Goupil M; Department of Medical Oncology, University Hospital, Bordeaux, France.
Jazyk: angličtina
Zdroj: Clinical genitourinary cancer [Clin Genitourin Cancer] 2022 Jun; Vol. 20 (3), pp. 297-297.e6. Date of Electronic Publication: 2022 Jan 14.
DOI: 10.1016/j.clgc.2022.01.009
Abstrakt: Introduction: Guidelines do not recommend FDG-PET CT for the staging of MIBC as a standard. The objectives of the study are to assess the accuracy of the FDG-PET CT for LN staging and to determine the rate of treatment modification according to FDG-PET CT results in MIBC.
Patients and Methods: From January 2005 to December 2017, we carried out a retrospective analysis of patients with MIBC who had a FDG-PET CT for staging in two expert centres in Bordeaux, France, and analyzed its clinical value in this setting. Nodal and metastatic staging on CT scan (CT) and FDG-PET CT were done independently.
Results: Accuracy of LN staging from CT and FDG-PET CT at initial diagnosis was analyzed in 85 patients (including 70 patients treated with neoadjuvant chemotherapy (NAC)) and compared to pathological examination of resected LN. Sensitivity of FDG-PET CT was better than CT (80.8% versus 26.9%) but the specificity was low (54.2% vs. 83.1%). The Youden index was better for FDG-PET CT (0.35; 0.1 for CT) and FDG-PET CT appeared to be more accurate for determining LN staging of MIBC. FDG-PET CT findings enabled a treatment decision modification in 34/130 patients (26.1%): a therapeutic intensification (9.2%), including surgery not previously planned and/or modified fields of radiotherapy; or a de-escalation (16.9%), mostly avoiding surgery.
Conclusion: FDG-PET CT was more sensitive for detection of LN involvement at initial diagnosis of MIBC than CT alone. In our study, treatment decisions were modified, according to FDG-PET CT results, in almost a quarter of patients.
(Copyright © 2022. Published by Elsevier Inc.)
Databáze: MEDLINE
Externí odkaz: