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Erschienen in:
01.10.2015 | Colorectal Cancer
The Role of FDG-PET in the Initial Staging and Response Assessment of Anal Cancer: A Systematic Review and Meta-analysis
Erschienen in: Annals of Surgical Oncology | Ausgabe 11/2015
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Purpose
The aim of this systematic review and meta-analysis was to compare the role of FDG-positron emission tomography (PET) or PET/computed tomography (CT) with conventional imaging in the detection of primary and nodal disease in anal cancer, and to assess the impact of PET or PET/CT on the management of anal cancer.
Methods
A systematic review of the literature was performed. Eligible studies included those comparing PET or PET/CT with conventional imaging in the staging of histologically confirmed anal squamous cell carcinoma (SCC), or studies that performed PET or PET/CT imaging to assess response following treatment.
Results
Twelve studies met the inclusion criteria. For the detection of primary disease, CT and PET had a sensitivity of 60 % (95 % confidence interval [CI] 45.5–75.2) and 99 % (95 % CI 96–100), respectively. Compared with conventional imaging, PET upstaged 15 % (95 % CI 10–21) and downstaged 15 % (95 % CI 10–20) of nodal disease. This led to a change in nodal staging in 28 % of patients (95 % CI 18–38). When only studies performing contemporary PET/CT were considered, the rate of nodal upstaging was 21 % (95 % CI 13–30) and the TNM stage was altered in 41 % of patients. Following chemoradiotherapy, 78 % (95 % CI 65–88) of patients had a complete response on PET.
Conclusion
Compared with conventional imaging, PET or PET/CT alters the nodal status in a sufficient number of cases to justify its routine use in the staging of patients with anal SCC.