18 F-Fludeoxyglucose-Positron Emission Tomography/Computed Tomography and Laparoscopy for Staging of Locally Advanced Gastric Cancer:A Multicenter Prospective Dutch Cohort Study (PLASTIC)

Verfasser:	Gertsen, Emma C. Brenkman, Hylke J.F. Van Hillegersberg, Richard Van Sandick, Johanna W. Van Berge Henegouwen, Mark I. Gisbertz, Suzanne S. Luyer, Misha D.P. Nieuwenhuijzen, Grard A.P. Van Lanschot, Jan J.B. Lagarde, Sjoerd M. Wijnhoven, Bas P.L. De Steur, Wobbe O. Hartgrink, Henk H. Stoot, Jan H.M.B. Hulsewe, Karel W.E. Spillenaar Bilgen, Ernst J. Van Det, Marc J. Kouwenhoven, Ewout A. Van Der Peet, Donald L. Daams, Freek Van Grieken, Nicole C.T. Heisterkamp, Joos Van Etten, Boudewijn Van Den Berg, Jan Willem Pierie, Jean Pierre Eker, Hasan H. Thijssen, Annemieke Y. Belt, Eric J.T. Van Duijvendijk, Peter Wassenaar, Eelco Van Laarhoven, Hanneke W.M. Wevers, Kevin P. Hol, Lieke Wessels, Frank J. Haj Mohammad, Nadia Van Der Meulen, Miriam P. Frederix, Geert W.J. Vegt, Erik Siersema, Peter D. Ruurda, Jelle P.
Dokumenttyp:	Artikel
Erscheinungsdatum:	2021
Reihe/Periodikum:	PLASTIC Study Group , Gertsen , E C , Brenkman , H J F , Van Hillegersberg , R , Van Sandick , J W , Van Berge Henegouwen , M I , Gisbertz , S S , Luyer , M D P , Nieuwenhuijzen , G A P , Van Lanschot , J J B , Lagarde , S M , Wijnhoven , B P L , De Steur , W O , Hartgrink , H H , Stoot , J H M B , Hulsewe , K W E , Spillenaar Bilgen , E J , Van Det , M J , Kouwenhoven , E A , Van Der Peet , D L , Daams , F , Van Grieken , N C T , Heisterkamp , J , Van Etten , B , Van Den Berg , J W , Pierie , J P , Eker , H H , Thijssen , A Y , Belt , E J T , Van Duijvendijk , P , Wassenaar , E , Van Laarhoven , H W M , Wevers , K P , Hol , L , Wessels , F J , Haj Mohammad , N , Van Der Meulen , M P , Frederix , G W J , Vegt , E , Siersema , P D & Ruurda , J P 2021 , ' 18 F-Fludeoxyglucose-Positron Emission Tomography/Computed Tomography and Laparoscopy for Staging of Locally Advanced Gastric Cancer : A Multicenter Prospective Dutch Cohort Study (PLASTIC) ' , JAMA Surgery , vol. 156 , no. 12 , pp. E1-E9 . https://doi.org/10.1001/jamasurg.2021.5340
Sprache:	Englisch
Permalink:	https://search.fid-benelux.de/Record/base-29445150
Datenquelle:	BASE; Originalkatalog
Powered By:	BASE
Link(s) :	https://hdl.handle.net/11370/eb1e42d9-cefc-48ae-8d8c-3de5fe5971fe

Importance: The optimal staging for gastric cancer remains a matter of debate. Objective: To evaluate the value of 18 F-fludeoxyglucose-positron emission tomography with computed tomography (FDG-PET/CT) and staging laparoscopy (SL) in addition to initial staging by means of gastroscopy and CT in patients with locally advanced gastric cancer. Design, Setting, and Participants: This multicenter prospective, observational cohort study included 394 patients with locally advanced, clinically curable gastric adenocarcinoma (=cT3 and/or N+, M0 category based on CT) between August 1, 2017, and February 1, 2020. Exposures: All patients underwent an FDG-PET/CT and/or SL in addition to initial staging. Main Outcomes and Measures: The primary outcome was the number of patients in whom the intent of treatment changed based on the results of these 2 investigations. Secondary outcomes included diagnostic performance, number of incidental findings on FDG-PET/CT, morbidity and mortality after SL, and diagnostic delay. Results: Of the 394 patients included, 256 (65%) were men and mean (SD) age was 67.6 (10.7) years. A total of 382 patients underwent FDG-PET/CT and 357 underwent SL. Treatment intent changed from curative to palliative in 65 patients (16%) based on the additional FDG-PET/CT and SL findings. FDG-PET/CT detected distant metastases in 12 patients (3%), and SL detected peritoneal or locally nonresectable disease in 73 patients (19%), with an overlap of 7 patients (2%). FDG-PET/CT had a sensitivity of 33% (95% CI, 17%-53%) and specificity of 97% (95% CI, 94%-99%) in detecting distant metastases. Secondary findings on FDG/PET were found in 83 of 382 patients (22%), which led to additional examinations in 65 of 394 patients (16%). Staging laparoscopy resulted in a complication requiring reintervention in 3 patients (0.8%) without postoperative mortality. The mean (SD) diagnostic delay was 19 (14) days. Conclusions and Relevance: This study's findings suggest an apparently limited additional value of FDG-PET/CT; however, ...