Positron emission tomography/computed tomography influences on the management of resectable pancreatic cancer and its cost-effectiveness.

Details

Serval ID
serval:BIB_91B85036F17D
Type
Article: article from journal or magazin.
Collection
Publications
Title
Positron emission tomography/computed tomography influences on the management of resectable pancreatic cancer and its cost-effectiveness.
Journal
Annals of surgery
Author(s)
Heinrich S., Goerres G.W., Schäfer M., Sagmeister M., Bauerfeind P., Pestalozzi B.C., Hany T.F., von Schulthess G.K., Clavien P.A.
ISSN
0003-4932 (Print)
ISSN-L
0003-4932
Publication state
Published
Issued date
08/2005
Peer-reviewed
Oui
Volume
242
Number
2
Pages
235-243
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
We sought to determine the impact of positron emission tomography/computed tomography (PET/CT) on the management of presumed resectable pancreatic cancer and to assess the cost of this new staging procedure.
PET using 18F-fluorodeoxyglucose (FDG) is increasingly used for the staging of pancreatic cancer, but anatomic information is limited. Integrated PET/CT enables optimal anatomic delineation of PET findings and identification of FDG-negative lesions on computed tomography (CT) images and might improve preoperative staging.
Patients with suspected pancreatic cancer who had a PET/CT between June 2001 to April 2004 were entered into a prospective database. Routine staging included abdominal CT, chest x-ray, and CA 19-9 measurement. FDG-PET/CT was conducted according to a standardized protocol, and findings were confirmed by histology. Cost benefit analysis was performed based on charged cost of PET/CT and pancreatic resection and included the time frame of staging and surgery.
Fifty-nine patients with a median age of 61 years (range, 40-80 years) were included in this analysis. Fifty-one patients had lesions in the head and 8 in the tail of the pancreas. The positive and negative predictive values for pancreatic cancer were 91% and 64%, respectively. PET/CT detected additional distant metastases in 5 and synchronous rectal cancer in 2 patients. PET/CT findings changed the management in 16% of patients with pancreatic cancer deemed resectable after routine staging (P = 0.031) and was cost saving.
PET/CT represents an important staging procedure prior to pancreatic resection for cancer, since it significantly improves patient selection and is cost-effective.
Keywords
Adenocarcinoma/diagnosis, Adenocarcinoma/surgery, Adult, Aged, Aged, 80 and over, Cost-Benefit Analysis, Female, Fluorodeoxyglucose F18, Humans, Male, Middle Aged, Neoplasm Staging/methods, Pancreatic Neoplasms/diagnosis, Pancreatic Neoplasms/surgery, Positron-Emission Tomography/economics, Predictive Value of Tests, Sensitivity and Specificity, Tomography, X-Ray Computed/economics
Pubmed
Web of science
Create date
11/12/2018 15:47
Last modification date
20/08/2019 15:54
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