The Impact of Positron Emission Tomography (PET) Imaging Prior to Liver Resection for Colorectal Adenocarcinoma Metastases: A Prospective, Multicentre Randomized Clinical Trial
Colorectal cancer remains a leading cause of death in men and women. A significant number of
patients with colorectal cancer will either present with, or subsequently develop, liver
metastases. In contrast to many other epithelial solid tumours, resection of colorectal
cancer hepatic metastases results in long-term survival and even cure. However, despite
state of the art CT imaging, 60-75% of patients who appear to have limited disease amenable
to surgical resection will eventually die from extra-hepatic and recurrent hepatic
metastases. If occult micrometastatic disease that becomes evident after liver resection
could be detected reliably during pre-operative assessment, patients harboring more
widespread disease could be spared a non-curative liver resection. This is one of the
present challenges of liver surgery. PET imaging has the potential to improve the detection
of both hepatic and extra-hepatic metastatic disease, not detected by conventional imaging
modalities.
This prospective, multicenter trial will enroll patients with colorectal cancer liver
metastases considered resectable, based on CT scans of the thorax, abdomen and pelvis, which
demonstrate no evidence of extra-hepatic disease. A full colonoscopy within the preceding 12
months will ensure there is no local recurrence, or other primary cancer at the time of
planned liver resection. These patients will be randomized to PET scan or not.
Interventional
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Diagnostic
proportion of patients who have a change in management resulting from PET
12 months
No
Steven Gallinger, MD
Study Chair
University Health Network: Mount Sinai Hospital
Canada: Health Canada
CTA-Control-098389
NCT00265356
November 2005
April 2013
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