FDG PET and PET/CT for the detection of the primary tumour in patients with cervical non-squamous cell carcinoma metastasis of an unknown primary

Paul, Stefan A. M.; Stoeckli, Sandro J.; Schulthess, Gustav K. von; Goerres, Gerhard W.

doi:10.1007/s00405-006-0177-9

Cited by 29 publications

(9 citation statements)

References 19 publications

(21 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Third, this EMR-and-encounter-based study was only meant to address the association between FDG PET and up-staging and/or survival. There are many other ways that FDG PET can clinically affect patients, including changing radiation treatment volumes, 21,22 detecting primary sites for HNC of unknown primary, 23 and improving surveillance after treatment. 24 None of these clinical outcomes was addressed in this study.…”

Section: Discussionmentioning

confidence: 99%

Positron Emission Tomography and Stage Migration in Head and Neck Cancer

VanderWalde

Salloum

Liu

et al. 2014

JAMA Otolaryngol Head Neck Surg

View full text Add to dashboard Cite

IMPORTANCE Since 2001, there has been a rapid adoption of positron emission tomography (PET) for diagnosis and American Joint Committee on Cancer (AJCC) staging of head and neck cancer (HNC) without data describing improved clinical outcomes. OBJECTIVE To determine the association between increased use of PET and stage and/or survival for patients with HNC in the managed care environment. DESIGN, SETTING, AND PARTICIPANTS Adult patients diagnosed as having HNC (n = 958) from 2000 to 2008 at 4 integrated health systems were identified via tumor registries linked to administrative data. The AJCC stage distribution, patient and treatment characteristics, and survival between pre-PET era (2000–2004) vs PET era (2005–2008) and use of PET vs no use of PET during the PET era were compared. The AJCC stages were categorized to represent localized (stage I or II), locally advanced (stage III, IVA, or IVB), and metastatic (stage IVC) disease. INTERVENTIONS Treatments were determined by billing codes for surgery, radiation treatment, and chemotherapy. MAIN OUTCOMES AND MEASURES The primary outcome for this study was the use of PET. Secondary outcomes included treatment received and 2-year survival. A logit model estimated the effects of PET on diagnosis of locally advanced disease. Kaplan-Meier estimates described overall survival differences between PET and non-PET. Cox regression evaluated the association of PET on survival in patients with locally advanced disease. RESULTS An association between PET and locally advanced disease was found (odds ratio, 2.86 [95% CI, 1.90–4.29) (P < .001). Two-year overall survival for patients with locally advanced disease with and without PET was 52% and 32%, respectively (P = .004), but there was no difference for all stages (P = .69). On Cox proportional hazard regression, PET had no association with survival in patients with locally advanced disease (hazard ratio, 1.208 [95% CI, 0.778–1.877]) (P = .40). CONCLUSIONS AND RELEVANCE The increasing use of PET among patients with HNC is associated with a greater number of patients with higher-stage disease and a dilution of the population with higher-stage disease with patients who have a better prognosis. Thus, the improved survival in patients with locally advanced disease likely reflects selection bias and stage migration. Further research on PET use among patients with HNC is necessary to determine if it results in improved treatment for individual patients.

show abstract

Section: Discussionmentioning

confidence: 99%

Positron Emission Tomography and Stage Migration in Head and Neck Cancer

VanderWalde

Salloum

Liu

et al. 2014

JAMA Otolaryngol Head Neck Surg

View full text Add to dashboard Cite

show abstract

“…1,6,7 We describe a patient with an angiosarcoma of the scalp that was detected initially by a patient's complaint of neck swelling and tenderness. Although reports indicate that cancers of unknown primary origin can be diagnosed by cervical lymphnode metastasis, 8,9,10 this is the first case report in which angiosarcoma of the scalp was diagnosed in this manner.…”

Section: Discussionmentioning

confidence: 83%

Angiosarcoma of the scalp diagnosed by the presence of neck inflammation: a case report

et al. 2012

View full text Add to dashboard Cite

Angiosarcoma is an uncommon malignancy, which spread out from the endothelial cells of vessels. Scalp angiosarcoma with cervical lymph node metastasis is particularly rare. This article describes a rare case of angiosarcoma of the scalp, presenting as neck inflammation. Imaging procedures such as computed tomography (CT), magnetic resonance image (MRI) and ultrasonography (US) were not sufficient to diagnose this case. A needle biopsy provided an effective and accurate diagnosis of cervical lymph node metastasis. Additional observation and physical examination was required to diagnose the origin of the primary cancerous lesion. Once the angiosarcoma diagnosis was confirmed histologically, sequential weekly and monthly docetaxel (DTX) treatment was effective in preventing reoccurrence. Nonetheless, the optimization of angiosarcoma treatment remains a future goal. Although patients generally describe pain and swelling at the primary lesion site, this patient complained only of painful neck inflammation, without any indication of pain or swelling of the scalp. A revised diagnostic protocol should note that cervical lymph node metastasis of unknown primary origin may result from angiosarcoma of the scalp.

show abstract

“…The rate of primary tumour detection by FDG-PET/CT found in our study is in agreement with most studies in literature, with site detection rates of between 21% and 47%. 13,14,15,16,17,18 The low rate of detection of primary in CUPS, by imaging modalities employed so far, attributed to various factor; spontaneous regression, immune modulated destruction of the primary cancer , faster proliferation rate of lymphnodal metastases .and removal of primary site by sloughing of a necrotic tumour from the gastrointestinal tract are discussed . Bronchogenic carcinoma mistaken for a lymph node metastasis may also be an explanation for an unsuccessful primary tumour search.…”

mentioning

confidence: 99%

“…Various other studies mentioned a wide range of false positive result (7 to 31 %). 14,15,16,17,18,19 These false positive result could be due to a few factors like a high physiological uptake in head and neck region and GIT. The small size of the tumour has also been attributed to missing the lesion on biopsy, wherein a sampling error, could lead to apparent false positive FDG -PET results.…”

mentioning

confidence: 99%

“…The positive predictive value (PPV) and negative predictive value (NPV) of our study was 95% and 80 % respectively, while it ranged between 33 to 88 % and 50 to 100 % respectively for studies conducted by other authors. 14,15,16,17,18,19 . This wide range in various studies have been attributed to the fact that higher sensitivity, specificity, PPV, and NPV were achieved in studies involving PET-CT coregistration, as compared to PET alone (which showed higher false positive results).…”

mentioning

confidence: 99%

See 1 more Smart Citation