UICC World Cancer Congress 2006

Objective: Diagnosis of LRRC based on anatomical imaging modalities, such as CT and MRI are limited, because of difficulty in distinguishing postoperative scar from tumor. We have demonstrated positron emission tomography (PET) using 18F-fluorodeoxy glucose (FDG) have clinical value in the diagnosis of LRRC (Ann Surg Oncol 12:561,2005). The aim of this study was to evaluate accuracy and treatment results of LRRC based on FDG-PET. Methods:Thirty patients (pts) who underwent surgical intervention for LRRC were evaluated. Twenty-one males and 9 females with median age of 59 at the diagnosis of LRRC (range 36 to 77). Twenty-four pts had operation for curative intent and the other 6 pts underwent palliative operation. FDG-PET was performed preoperatively in all pts. In all patients, histological diagnosis was made based on resected specimen. Results:Surgical procedure, tumorectomy; 6, low anterior resection; 5, abdomino-perineal resection; 2, total pelvic exenteration; 17. Sacrectomy was accompanied in 18 procedures. Median operation time was 900 min (range 285 to 1500 min), median blood loss was 5150 g (range 310 to 60600 g). R0 operation was achieved in 21 pts (88%) for curative intent. FDG-uptake was detected in 28 pts, and histological confirmation of LRRC was demonstrated in all pts. At median follow-up of 32 months, overall survival and local recurrence free survival at 3 years was 56.4%, and 59.4%, respectively. Conclusion:Molecular imaging using FDG-PET allows us to evaluate accurate diagnosis and tumor expansion before surgical intervention, which resulted in extended surgery but may provide good impact on prognosis.