18F-Fludeoxyglucose-Positron Emission Tomography/Computed Tomography and Laparoscopy for Staging of Locally Advanced Gastric Cancer: A Multicenter Prospective Dutch Cohort Study (PLASTIC)
| Autor: | Miriam P. van der Meulen, Emma C. Gertsen, Jessy Joy van Kleef, Grard A. P. Nieuwenhuijzen, Edith Bouwmeester, Annemieke Y. Thijssen, Mariska Prins, Marc J. van Det, F. Daams, Nicole C.T. van Grieken, Boudewijn van Etten, Mark I. van Berge Henegouwen, Ernst J. Spillenaar Bilgen, Nadia Haj Mohammad, Jan H. M. B. Stoot, Jan W.K. van den Berg, Eelco Wassenaar, Monique Heijmans, Ilse Masselink, Lieke Hol, Kees de Mooij, Antoinette van Groenestyn, Jean Pierre Pierie, Peter van Duijvendijk, Misha D. P. Luyer, Stan Tummers, Richard van Hillegersberg, Kevin P. Wevers, Peter D. Siersema, Jerôme Profar, J. Jan B. van Lanschot, Ewout A. Kouwenhoven, Joyce Pijpers, Eric J. Th. Belt, Geert W.J. Frederix, Nel de Vries, Hanneke W. M. van Laarhoven, Sjoerd M. Lagarde, E. Vegt, Hasan H. Eker, Donald L. van der Peet, Jelle P. Ruurda, Hylke J. F. Brenkman, Wobbe O. de Steur, Bas P. L. Wijnhoven, Johanna W. van Sandick, Damiana Beumer, Henk H. Hartgrink, Suzanne S. Gisbertz, Frank J. Wessels, Karel W. E. Hulsewe, Maaike van Dam, Joos Heisterkamp |
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| Přispěvatelé: | Surgery, Radiology & Nuclear Medicine, CCA - Imaging and biomarkers, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, Oncology, VU University medical center, Amsterdam Gastroenterology Endocrinology Metabolism, Pathology, Internal medicine |
| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Palliative care Locally advanced Computed tomography Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14] SDG 3 - Good Health and Well-being Gastrectomy Fluorodeoxyglucose F18 Stomach Neoplasms Positron Emission Tomography Computed Tomography Medicine Humans Prospective Studies Laparoscopy Original Investigation Aged Neoplasm Staging Netherlands medicine.diagnostic_test business.industry Cancer medicine.disease Positron emission tomography Surgery Female Radiology Radiopharmaceuticals Tomography X-Ray Computed business Complication Cohort study |
| Zdroj: | JAMA Surgery, 156 JAMA Surgery, 156(12):e215340, E1-E9. American Medical Association JAMA surgery, 156(12), E1-E9. American Medical Association JAMA Surgery, 156(12), E1-E9. American Medical Association JAMA Surgery, 156, 12 JAMA Surg JAMA Surgery, 156(12), E1-E9. AMER MEDICAL ASSOC Gertsen, E C, Brenkman, H J F, van Hillegersberg, R, van Sandick, J W, van Berge Henegouwen, M I, Gisbertz, S S, Luyer, M D P, Nieuwenhuijzen, G A P, van Lanschot, J J B, Lagarde, S M, Wijnhoven, B P L, de Steur, W O, Hartgrink, H H, Stoot, J H M B, Hulsewe, K W E, Spillenaar Bilgen, E J, van Det, M J, Kouwenhoven, E A, van der Peet, D L, Daams, F, van Grieken, N C T, Heisterkamp, J, van Etten, B, van den Berg, J W, Pierie, J P, Eker, H H, Thijssen, A Y, Belt, E J T, van Duijvendijk, P, Wassenaar, E, van Laarhoven, H W M, Wevers, K P, Hol, L, Wessels, F J, Haj Mohammad, N, van der Meulen, M P, Frederix, G W J, Vegt, E, Siersema, P D & Ruurda, J P 2021, ' 18F-Fludeoxyglucose-Positron Emission Tomography/Computed Tomography and Laparoscopy for Staging of Locally Advanced Gastric Cancer : A Multicenter Prospective Dutch Cohort Study (PLASTIC) ', JAMA Surgery, vol. 156, no. 12, pp. E1-E9 . https://doi.org/10.1001/jamasurg.2021.5340 |
| ISSN: | 2168-6254 |
| DOI: | 10.1001/jamasurg.2021.5340 |
| Popis: | Importance: The optimal staging for gastric cancer remains a matter of debate. Objective: To evaluate the value of 18F-fludeoxyglucose-positron emission tomography with computed tomography (FDG-PET/CT) and staging laparoscopy (SL) in addition to initial staging by means of gastroscopy and CT in patients with locally advanced gastric cancer. Design, Setting, and Participants: This multicenter prospective, observational cohort study included 394 patients with locally advanced, clinically curable gastric adenocarcinoma (=cT3 and/or N+, M0 category based on CT) between August 1, 2017, and February 1, 2020. Exposures: All patients underwent an FDG-PET/CT and/or SL in addition to initial staging. Main Outcomes and Measures: The primary outcome was the number of patients in whom the intent of treatment changed based on the results of these 2 investigations. Secondary outcomes included diagnostic performance, number of incidental findings on FDG-PET/CT, morbidity and mortality after SL, and diagnostic delay. Results: Of the 394 patients included, 256 (65%) were men and mean (SD) age was 67.6 (10.7) years. A total of 382 patients underwent FDG-PET/CT and 357 underwent SL. Treatment intent changed from curative to palliative in 65 patients (16%) based on the additional FDG-PET/CT and SL findings. FDG-PET/CT detected distant metastases in 12 patients (3%), and SL detected peritoneal or locally nonresectable disease in 73 patients (19%), with an overlap of 7 patients (2%). FDG-PET/CT had a sensitivity of 33% (95% CI, 17%-53%) and specificity of 97% (95% CI, 94%-99%) in detecting distant metastases. Secondary findings on FDG/PET were found in 83 of 382 patients (22%), which led to additional examinations in 65 of 394 patients (16%). Staging laparoscopy resulted in a complication requiring reintervention in 3 patients (0.8%) without postoperative mortality. The mean (SD) diagnostic delay was 19 (14) days. Conclusions and Relevance: This study's findings suggest an apparently limited additional value of FDG-PET/CT; however, SL added considerably to the staging process of locally advanced gastric cancer by detection of peritoneal and nonresectable disease. Therefore, it may be useful to include SL in guidelines for staging advanced gastric cancer, but not FDG-PET/CT.. |
| Databáze: | OpenAIRE |
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