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The Role of FDG-PET in the Initial Staging and Response Assessment of Anal Cancer: A Systematic Review and Meta-analysis

Annals of Surgical Oncology, ISSN: 1534-4681, Vol: 22, Issue: 11, Page: 3574-3581
2015
  • 104
    Citations
  • 0
    Usage
  • 52
    Captures
  • 0
    Mentions
  • 0
    Social Media
Metric Options:   Counts1 Year3 Year

Metrics Details

  • Citations
    104
    • Citation Indexes
      97
    • Policy Citations
      5
      • Policy Citation
        5
    • Clinical Citations
      2
      • PubMed Guidelines
        2
  • Captures
    52

Article Description

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.

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