Bailey Christina E, Hu Chung-Yuan, You Y Nancy, Kaur Harmeet, Ernst Randy D, Chang George J
University of Texas MD Anderson Cancer Center, Houston, TX.
University of Texas MD Anderson Cancer Center, Houston, TX
J Oncol Pract. 2015 May;11(3):e363-72. doi: 10.1200/JOP.2014.001933. Epub 2015 Apr 7.
Colon cancer surveillance guidelines do not routinely include positron emission tomography (PET) imaging; however, its use after surgical resection has been increasing. We evaluated the secular patterns of PET use after surgical resection of colon cancer among elderly patients and identified factors associated with its increasing use.
We used the SEER-linked Medicare database (July 2001 through December 2009) to establish a retrospective cohort of patients age ≥ 66 years who had undergone surgical resection for colon cancer. Postoperative PET use was assessed with the test for trends. Patient, tumor, and treatment characteristics were analyzed using univariable and multivariable logistic regression analyses.
Of the 39,221 patients with colon cancer, 6,326 (16.1%) had undergone a PET scan within 2 years after surgery. The use rate steadily increased over time. The majority of PET scans had been performed within 2 months after surgery. Among patients who had undergone a PET scan, 3,644 (57.6%) had also undergone preoperative imaging, and 1,977 (54.3%) of these patients had undergone reimaging with PET within 2 months after surgery. Marriage, year of diagnosis, tumor stage, preoperative imaging, postoperative visit to a medical oncologist, and adjuvant chemotherapy were significantly associated with increased PET use.
PET use after colon cancer resection is steadily increasing, and further study is needed to understand the clinical value and effectiveness of PET scans and the reasons for this departure from guideline-concordant care.
结肠癌监测指南通常不包括正电子发射断层扫描（PET）成像；然而，其在手术切除后的应用一直在增加。我们评估了老年患者结肠癌手术切除后PET使用的长期模式，并确定了与其使用增加相关的因素。
我们使用SEER相关的医疗保险数据库（2001年7月至2009年12月）建立了一个回顾性队列，纳入年龄≥66岁且接受过结肠癌手术切除的患者。通过趋势检验评估术后PET的使用情况。使用单变量和多变量逻辑回归分析对患者、肿瘤和治疗特征进行分析。
在39221例结肠癌患者中，6326例（16.1%）在术后2年内接受了PET扫描。使用率随时间稳步上升。大多数PET扫描在术后2个月内进行。在接受PET扫描的患者中，3644例（57.6%）也接受了术前成像，其中1977例（54.3%）在术后2个月内接受了PET再次成像。婚姻状况、诊断年份、肿瘤分期、术前成像、术后拜访肿瘤内科医生以及辅助化疗与PET使用增加显著相关。
结肠癌切除术后PET的使用在稳步增加，需要进一步研究以了解PET扫描的临床价值和有效性，以及这种偏离指南一致性护理的原因。
