Annals of Coloproctology

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Reliability of ¹⁸F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography in the Nodal Staging of Colorectal Cancer Patients: Hee Jung Yi, Kyung Sook Hong, Nara Moon, Soon Sup Chung, Ryung-Ah Lee, Kwang Ho Kim; Ann Coloproctol. 2014;30(6):259-265. Published online December 31, 2014; DOI: https://doi.org/10.3393/ac.2014.30.6.259

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Purpose

Lymph-node metastasis is considered as critical prognostic factor in colorectal cancer. A preoperative evaluation of lymph-node metastasis can also help to determine the range of distant lymph node dissection. However, the reliability of ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) in the detection of lymph-node metastasis is not fully known.

Methods

The medical records of 433 patients diagnosed with colorectal cancer were reviewed retrospectively. FDG-PET/CT and CT were performed on all patients. Lymph nodes were classified into regional and distant lymph nodes according to the American Joint Committee on Cancer (AJCC) Cancer Staging Manual, 7th edition.

Results

The patients included 231 males (53.3%) and 202 females (46.7%), with a mean age of 64.7 ± 19.0 years. For regional lymph nodes, the sensitivity of FDG-PET/CT was lower than that of CT (57.1% vs. 73.5%, P < 0.001). For distant lymph nodes, the sensitivity of FDG-PET/CT was higher than that of CT (64.7% vs. 52.9%, P = 0.012). The sensitivity of FDG-PET/CT for regional lymph nodes was higher in patients with larger primary tumors. The positivity of lymph-node metastasis for FDG-PET/CT was affected by carcinoembryonic antigen levels, tumor location, and cancer stage for regional lymph nodes and by age and cancer stage for distant lymph nodes (P < 0.05).

Conclusion

The sensitivity of FDG-PET/CT for regional lymph-node metastasis was not superior to that of CT. However, FDG-PET/CT provides helpful information for determining surgical plan especially in high risk patients group.

Citations

Citations to this article as recorded by

Evaluation of colon cancer prognostic factors by CT and MRI: an up-to-date review
Ruggeri B. Guimarães, Eduardo O. Pacheco, Serli N. Ueda, Dario A. Tiferes, Fernanda L. Mazzucato, Aley Talans, Ulysses S. Torres, Giuseppe D’Ippolito
Abdominal Radiology.2024; 49(11): 4003. CrossRef
Tomographie par émission de positons en cancérologie digestive
C. Aveline, F. Montravers
EMC - Radiologie et imagerie médicale - Abdominale - Digestive.2024; 42(1): 1. CrossRef
Can Cross-Sectional Imaging Reliably Determine Pathological Staging of Right-Sided Colon Cancers and Select Patients for More Radical Surgery or Neo-Adjuvant Treatment?
Florence Shekleton, Edward Courtney, Adrian Andreou, John Bunni
Cureus.2022;[Epub] CrossRef
Colorectal cancer: Parametric evaluation of morphological, functional and molecular tomographic imaging
Pier Paolo Mainenti, Arnaldo Stanzione, Salvatore Guarino, Valeria Romeo, Lorenzo Ugga, Federica Romano, Giovanni Storto, Simone Maurea, Arturo Brunetti
World Journal of Gastroenterology.2019; 25(35): 5233. CrossRef
Clinical evaluation of18F-fludeoxyglucose positron emission tomography/CT using point spread function reconstruction for nodal staging of colorectal cancer
Kazuya Kawashima, Kenichi Kato, Makiko Tomabechi, Mikaru Matsuo, Koki Otsuka, Kazuyuki Ishida, Ryuji Nakamura, Shigeru Ehara
The British Journal of Radiology.2016; 89(1063): 20150938. CrossRef
Short-term and oncologic outcomes of laparoscopic and open complete mesocolic excision and central ligation
Ik Yong Kim, Bo Ra Kim, Eun Hee Choi, Young Wan Kim
International Journal of Surgery.2016; 27: 151. CrossRef
Preoperative Staging With Positron Emission Tomography in Patients With Colorectal Cancer
Young Wan Kim, Ik Yong Kim
Annals of Coloproctology.2014; 30(6): 247. CrossRef

Optimal Time of Initiating Adjuvant Chemotherapy After Curative Surgery in Colorectal Cancer Patients: Kyu Min Kang, Kyung Sook Hong, Gyoung Tae Noh, Bo-Young Oh, Soon Sup Chung, Ryung-Ah Lee, Kwang Ho Kim; Ann Coloproctol. 2013;29(4):150-154. Published online August 29, 2013; DOI: https://doi.org/10.3393/ac.2013.29.4.150

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14 Citations

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Purpose

Adjuvant chemotherapy is routinely recommended for locally advanced colorectal cancer (CRC). There are very few data for the optimal starting date of adjuvant chemotherapy after the surgery. This study aimed to evaluate the effectiveness of earlier adoption of adjuvant chemotherapy after curative surgery for stage III CRC.

Methods

In this study, 159 patients with stage III CRC, who had undergone a curative resection, were enrolled retrospectively. Patients were categorized into 3 groups representing different timings to initiate the chemotherapy; less than 2 weeks (group 1), 3 to 4 weeks (group 2), and more than 5 weeks (group 3). The overall survival rate (OS) and the relapse-free survival rate (RFS) were analyzed to evaluate the effectiveness of adjuvant chemotherapy.

Results

The 5-year OSs of the patients were 73.7% in group 1, 67.0% in group 2, and 55.2% in group 3. The 5-year RFSs of the patients were 48.8% in group 1, 64.7% in group 2, and 57.1% in group 3. There were no significant differences in either the OS or the RFS (P = 0.200, P = 0.405).

Conclusion

Starting chemotherapy earlier than 6 weeks after surgery does not show any significant difference. Thus, although adjuvant chemotherapy should preferably begin within 6 weeks, the starting date should not necessarily be hastened, and the patient's general condition should be taken into consideration.

Citations

Citations to this article as recorded by

Optimal timing of cancer treatments: a call for emerging evidence from clinical trials and real-world studies
Jianrong Zhang, Rebecca Venchiarutti, Xiaofei Wang, Qihua He
British Journal of Cancer.2025; 132(12): 1085. CrossRef
Minimally Invasive Approach Provides Oncological Benefit in Patients with High Risk of Very Early Recurrence (VER) After Surgery for Intrahepatic Cholangiocarcinoma (iCCA)
Francesca Ratti, Cecilia Maina, Lucrezia Clocchiatti, Rebecca Marino, Federica Pedica, Andrea Casadei Gardini, Francesco De Cobelli, Luca Antonio Maria Aldrighetti
Annals of Surgical Oncology.2024; 31(4): 2557. CrossRef
The optimal time of starting adjuvant chemotherapy after curative surgery in patients with colorectal cancer
Yuchong Yang, Yao Lu, Hui Tan, Ming Bai, Xia Wang, Shaohua Ge, Tao Ning, Le Zhang, Jingjing Duan, Yansha Sun, Rui Liu, Hongli Li, Yi Ba, Ting Deng
BMC Cancer.2023;[Epub] CrossRef
Apurinic/apyrimidinic endonuclease 1 is associated with poor prognosis after curative resection followed by adjuvant chemotherapy in patients with stage III colon cancer
Ji Hyeong Song, Myung Sun Lee, Eun Young Cha, Kyung Ha Lee, Ji Yeon Kim, Jin Soo Kim
Korean Journal of Clinical Oncology.2022; 18(1): 1. CrossRef
Impact of the Time Interval Between Primary Debulking Surgery and Start of Adjuvant Chemotherapy in Advanced Epithelial Ovarian Cancer
Hao Lin, Wen-Hsin Chen, Chen-Hsuan Wu, Yu-Che Ou, Yu-Jen Chen, Ying-Yi Chen, Yu-Han Lin, Hung-Chun Fu
Cancer Management and Research.2021; Volume 13: 5413. CrossRef
Bevacizumab and erlotinib versus bevacizumab for colorectal cancer treatment: systematic review and meta-analysis
Sara Kaveh, Parvin Ebrahimi, Aziz Rezapour, Masoud Mozafari, Kourosh Sayehmiri
International Journal of Clinical Pharmacy.2019; 41(1): 30. CrossRef
Timing of Adjuvant Chemotherapy and Survival in Colorectal, Gastric, and Pancreatic Cancer. A Systematic Review and Meta-Analysis
Fausto Petrelli, Alberto Zaniboni, Antonio Ghidini, Michele Ghidini, Luca Turati, Claudio Pizzo, Margherita Ratti, Michela Libertini, Gianluca Tomasello
Cancers.2019; 11(4): 550. CrossRef
Safety and feasibility of in-hospital early chemotherapy initiation after surgery in patients with stage II–IV colon cancer
Jeonghyun Kang, Su-Weon Chong, Eun Jung Park, Seung Hyuk Baik, Kang Young Lee
Medicine.2019; 98(18): e15371. CrossRef
Surgical stress response and promotion of metastasis in colorectal cancer: a complex and heterogeneous process
Corina Behrenbruch, Carolyn Shembrey, Sophie Paquet-Fifield, Christina Mølck, Hyun-Jung Cho, Michael Michael, Benjamin N. J. Thomson, Alexander G. Heriot, Frédéric Hollande
Clinical & Experimental Metastasis.2018; 35(4): 333. CrossRef
Intensity modulated radiotherapy delivers competitive local control rate with limited acute toxicity in the adjuvant treatment of rectal cancer
Cheng-Yen Lee, Chih-Chia Chang, Hsin-Yi Yang, Pin-Yi Chiang, Yuk-Wah Tsang
Japanese Journal of Clinical Oncology.2018; 48(7): 653. CrossRef
Molecular analysis of sentinel lymph node in colon carcinomas by one-step nucleic acid amplification (OSNA) reduces time to adjuvant chemotherapy interval
Alix Marhic, Jean-François Tremblay, Rachid Kaci, Thierry André, Clarisse Eveno, Marc Pocard
Digestive and Liver Disease.2017; 49(8): 924. CrossRef
Timely initiation of chemotherapy: a systematic literature review of six priority cancers – results and recommendations for clinical practice
M. Alexander, R. Blum, K. Burbury, J. Coutsouvelis, M. Dooley, O. Fazil, T. Griffiths, H. Ismail, S. Joshi, N. Love, S. Opat, P. Parente, N. Porter, E. Ross, J. Siderov, P. Thomas, S. White, S. Kirsa, D. Rischin
Internal Medicine Journal.2017; 47(1): 16. CrossRef
Association Between Time (Initiation and Length) and Oncological Outcomes for the Patients with Colon Cancer Treated with Adjuvant Chemotherapy
In Seob Jeong, Jong Han Yoo, Sang Hyuk Seo, Min Sung An, Kwang Hee Kim, Ki Beom Bae, Chang Soo Choi, Jin Won Hwang, Ji Hyun Kim, Mi Seon Kang, Min Kyung Oh, Kwan Hee Hong
Indian Journal of Surgery.2015; 77(S3): 1252. CrossRef
Timing of Adjuvant Chemotherapy in Colorectal Cancer Patients
Moo-Jun Baek
Annals of Coloproctology.2013; 29(4): 138. CrossRef

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