Assessing the impact of FDG-PET in the management of anal cancer Academic Article uri icon

abstract

  • PURPOSE: To assess the utility of FDG-PET in anal cancer for staging and impact on radiotherapy planning (RTP), response and detection of recurrent disease. METHODS AND MATERIALS: Fifty histopathological anal cancer patients were reviewed between 1996 and 2006. The median age was 58 years (range 36-85) with 19 males:31females. Clinical assessment with CT was compared to PET. Impact on management, disease response, recurrence and metastases was evaluated. RESULTS: The non-PET staging was Stage I(8), Stage II(18), Stage III(22), and Stage IV(2)s. The primary was strongly FDG avid in 98% with non-excised tumors compared to CT (58%). PET upstaged 17% with unsuspected pelvic/inguinal nodal disease. Pre-treatment PET identified 11 additional by involved nodal groups in 48 patients causing RTP amendments in 19%. Post-treatment PETs at median 17 weeks (range 9-28) showed complete responses in 20 (80%) and 5 (20%) partial responses (PR). PRs were biopsy positive in 2 and negative in 3. Fifteen had follow-up scans of which all nine PETs detected recurrences were pathologically confirmed. CONCLUSIONS: Anal cancer is FDG-PET avid. PET upstages 17% and changes the RTP in 19%. PET can aid in anal cancer staging and identification of residual disease, recurrent/metastatic disease but warrants further prospective studies.

authors

  • Nguyen, Brandon T
  • Joon, Daryl Lim
  • Khoo, Vincent
  • Quong, George
  • Chao, Michael
  • Wada, Morikatsu
  • Joon, Michael Lim
  • See, Andrew
  • Feigen, Malcolm
  • Rykers, Kym
  • Kai, Cynleen
  • Zupan, Eddy
  • Scott, Andrew

publication date

  • June 2008