1. Impact of PET/CT on clinical management in patients with cancer of unknown primary-a PET/CT registry study.
- Author
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Reinert CP, Sekler J, la Fougère C, Pfannenberg C, and Gatidis S
- Subjects
- Adenocarcinoma secondary, Adenocarcinoma therapy, Aged, Bone Neoplasms diagnostic imaging, Bone Neoplasms secondary, Bone Neoplasms therapy, Brain Neoplasms diagnostic imaging, Brain Neoplasms secondary, Brain Neoplasms therapy, Carcinoma, Squamous Cell secondary, Carcinoma, Squamous Cell therapy, Clinical Decision-Making, Disease Management, Female, Humans, Liver Neoplasms diagnostic imaging, Liver Neoplasms secondary, Liver Neoplasms therapy, Lung Neoplasms diagnostic imaging, Lung Neoplasms secondary, Lung Neoplasms therapy, Lymph Nodes, Male, Middle Aged, Neuroendocrine Tumors secondary, Neuroendocrine Tumors therapy, Palliative Care, Prognosis, Radiopharmaceuticals, Registries, Surveys and Questionnaires, Adenocarcinoma diagnostic imaging, Carcinoma, Squamous Cell diagnostic imaging, Neoplasms, Unknown Primary diagnostic imaging, Neoplasms, Unknown Primary therapy, Neuroendocrine Tumors diagnostic imaging, Positron Emission Tomography Computed Tomography
- Abstract
Objective: To evaluate the impact of PET/CT on clinical management in patients with cancer of unknown primary (CUP)., Methods: A cohort of patients with CUP undergoing PET/CT was prospectively enrolled in a local PET/CT registry study between April 2013 and June 2018. Questionnaire data from referring physicians on intended patient management prior and after PET/CT were recorded including items on the intended treatment concept and intended additional diagnostics. Changes in management after PET/CT were recorded. Patient outcome of different cohorts was analyzed for overall survival drawn from patient records., Results: One hundred fifty-five patients (53 female; 63.4 ± 12.1 years) were included. Intended therapeutic management was revised in 45.8% of patients after PET/CT, including major changes affecting the intended treatment goal in 26.5% of patients and minor changes (therapy adjustments) in 19.3% of patients. Invasive and additional diagnostic procedures were intended in 25.8% and 63.2% prior PET/CT and 13.5% and 6.5% after PET/CT. PET/CT-based curative therapy concepts were associated with significantly longer patient survival (4.7 ± 0.3 years) than palliative therapy concepts (1.8 ± 0.5 years, p = .0001). Patients with cervical CUP showed a significantly longer survival (4.3 ± 0.3 years) than patients with extracervical CUP (3.5 ± 0.5 years, p = .01). The identification of the primary did not significantly affect survival., Conclusion: This registry study confirms previous studies reporting that PET/CT significantly influences clinical management in patients with CUP, helping physicians to select a more individualized treatment and to avoid additional diagnostics. Furthermore, we could confirm that tumor localization and extent as shown by PET/CT have a significant impact on patient prognosis., Key Points: • PET/CT significantly influences intended clinical management in patients with CUP, helping physicians to select a more individualized treatment and to avoid additional diagnostics. • Tumor localization and extent as shown by PET/CT have a significant impact on patient prognosis. • The identification of the primary tumor has no significant impact on overall patient survival.
- Published
- 2020
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