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How [18F]-FDG-PET/CT Affects Clinical Management of Patients with Germ Cell Tumors in the Real World

SIMPLE SUMMARY: This study aimed to assess the impact of PET/CT on the management of patients with germ cell tumors (GCTs) in a real-world setting, specifically in terms of avoiding invasive procedures, reducing additional diagnostic imaging, and influencing treatment decisions. A total of 43 male G...

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Autores principales: Liang, Cecilia, Sekler, Julia, Gückel, Brigitte, Pfannenberg, Christina, Dittmann, Helmut, Seith, Ferdinand, Amend, Bastian, Nikolaou, Konstantin, Reinert, Christian Philipp
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10377569/
https://www.ncbi.nlm.nih.gov/pubmed/37509313
http://dx.doi.org/10.3390/cancers15143652
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author Liang, Cecilia
Sekler, Julia
Gückel, Brigitte
Pfannenberg, Christina
Dittmann, Helmut
Seith, Ferdinand
Amend, Bastian
Nikolaou, Konstantin
Reinert, Christian Philipp
author_facet Liang, Cecilia
Sekler, Julia
Gückel, Brigitte
Pfannenberg, Christina
Dittmann, Helmut
Seith, Ferdinand
Amend, Bastian
Nikolaou, Konstantin
Reinert, Christian Philipp
author_sort Liang, Cecilia
collection PubMed
description SIMPLE SUMMARY: This study aimed to assess the impact of PET/CT on the management of patients with germ cell tumors (GCTs) in a real-world setting, specifically in terms of avoiding invasive procedures, reducing additional diagnostic imaging, and influencing treatment decisions. A total of 43 male GCT patients were included in this study, and their intended management before and after PET/CT was documented. The results showed that PET/CT caused changes in oncologic staging in 51% of patients, with 16% of patients upstaged, 23% of patients downstaged, and 11% of patients experiencing cancer relapse. Although the number of patients receiving curative treatment remained stable, there were notable changes in the intended therapeutic interventions. Planned chemotherapy increased from three to eleven patients, while planned surgical resection decreased from eleven to two patients. Moreover, PET/CT helped to avoid invasive procedures in 19% of cases and to reduce the need for additional diagnostic procedures in 58% of cases. In conclusion, the use of PET/CT had a significant impact on the clinical stage, resulting in a reduction in invasive and diagnostic procedures. These findings are expected to have even greater significance in the future as treatment options improve and GCT patient survival rates increase. ABSTRACT: Objective: The aim of this study was to evaluate the impact of PET/CT on clinical management of patients with germ cell tumors (GCTs) conducted in a real-world setting, including avoidance of invasive procedures, additional diagnostic imaging, and changes in treatment. Methods: Patients with GCTs were prospectively enrolled into a PET/CT registry study between May 2013 and April 2021. Intended patient management prior and after PET/CT was documented using standardized questionnaires. Changes in oncologic staging and clinical management after PET/CT were recorded, including planned treatment and planned additional diagnostics. Results: Forty-three male patients with GCTs were included consecutively in this study. After PET/CT, oncologic staging changed in 22/43 patients (51%), with upstaging in seven cases (16%), downstaging in ten cases (23%), and cancer relapse in five cases (11%). The number of patients with intended curative treatment remained stable, while a considerable change in intended therapeutic intervention was noted after PET/CT, with an increase in planned chemotherapy from three to eleven patients and a decrease in planned surgical resection from eleven to two patients. In addition, PET/CT contributed to preventing patients from intended invasive procedures including biopsy and surgery in 8/43 (19%) cases and from additional diagnostic procedures in 25 (58%) cases. Conclusion: With the use of FDG-PET/CT as a tool to guide patient management in GCTs, we observed a notable impact on clinical staging and a consequent reduction in the need for additional invasive and diagnostic procedures. These findings are expected to be even more consequential in the future as treatment modalities improve and the life expectancy of GCT patients further increases. Key Points: PET/CT considerably influences the clinical stage of GCT patients. PET/CT has remarkable influence on the choice of therapeutic interventions and reduces additional diagnostic procedures.
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spelling pubmed-103775692023-07-29 How [18F]-FDG-PET/CT Affects Clinical Management of Patients with Germ Cell Tumors in the Real World Liang, Cecilia Sekler, Julia Gückel, Brigitte Pfannenberg, Christina Dittmann, Helmut Seith, Ferdinand Amend, Bastian Nikolaou, Konstantin Reinert, Christian Philipp Cancers (Basel) Article SIMPLE SUMMARY: This study aimed to assess the impact of PET/CT on the management of patients with germ cell tumors (GCTs) in a real-world setting, specifically in terms of avoiding invasive procedures, reducing additional diagnostic imaging, and influencing treatment decisions. A total of 43 male GCT patients were included in this study, and their intended management before and after PET/CT was documented. The results showed that PET/CT caused changes in oncologic staging in 51% of patients, with 16% of patients upstaged, 23% of patients downstaged, and 11% of patients experiencing cancer relapse. Although the number of patients receiving curative treatment remained stable, there were notable changes in the intended therapeutic interventions. Planned chemotherapy increased from three to eleven patients, while planned surgical resection decreased from eleven to two patients. Moreover, PET/CT helped to avoid invasive procedures in 19% of cases and to reduce the need for additional diagnostic procedures in 58% of cases. In conclusion, the use of PET/CT had a significant impact on the clinical stage, resulting in a reduction in invasive and diagnostic procedures. These findings are expected to have even greater significance in the future as treatment options improve and GCT patient survival rates increase. ABSTRACT: Objective: The aim of this study was to evaluate the impact of PET/CT on clinical management of patients with germ cell tumors (GCTs) conducted in a real-world setting, including avoidance of invasive procedures, additional diagnostic imaging, and changes in treatment. Methods: Patients with GCTs were prospectively enrolled into a PET/CT registry study between May 2013 and April 2021. Intended patient management prior and after PET/CT was documented using standardized questionnaires. Changes in oncologic staging and clinical management after PET/CT were recorded, including planned treatment and planned additional diagnostics. Results: Forty-three male patients with GCTs were included consecutively in this study. After PET/CT, oncologic staging changed in 22/43 patients (51%), with upstaging in seven cases (16%), downstaging in ten cases (23%), and cancer relapse in five cases (11%). The number of patients with intended curative treatment remained stable, while a considerable change in intended therapeutic intervention was noted after PET/CT, with an increase in planned chemotherapy from three to eleven patients and a decrease in planned surgical resection from eleven to two patients. In addition, PET/CT contributed to preventing patients from intended invasive procedures including biopsy and surgery in 8/43 (19%) cases and from additional diagnostic procedures in 25 (58%) cases. Conclusion: With the use of FDG-PET/CT as a tool to guide patient management in GCTs, we observed a notable impact on clinical staging and a consequent reduction in the need for additional invasive and diagnostic procedures. These findings are expected to be even more consequential in the future as treatment modalities improve and the life expectancy of GCT patients further increases. Key Points: PET/CT considerably influences the clinical stage of GCT patients. PET/CT has remarkable influence on the choice of therapeutic interventions and reduces additional diagnostic procedures. MDPI 2023-07-17 /pmc/articles/PMC10377569/ /pubmed/37509313 http://dx.doi.org/10.3390/cancers15143652 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Liang, Cecilia
Sekler, Julia
Gückel, Brigitte
Pfannenberg, Christina
Dittmann, Helmut
Seith, Ferdinand
Amend, Bastian
Nikolaou, Konstantin
Reinert, Christian Philipp
How [18F]-FDG-PET/CT Affects Clinical Management of Patients with Germ Cell Tumors in the Real World
title How [18F]-FDG-PET/CT Affects Clinical Management of Patients with Germ Cell Tumors in the Real World
title_full How [18F]-FDG-PET/CT Affects Clinical Management of Patients with Germ Cell Tumors in the Real World
title_fullStr How [18F]-FDG-PET/CT Affects Clinical Management of Patients with Germ Cell Tumors in the Real World
title_full_unstemmed How [18F]-FDG-PET/CT Affects Clinical Management of Patients with Germ Cell Tumors in the Real World
title_short How [18F]-FDG-PET/CT Affects Clinical Management of Patients with Germ Cell Tumors in the Real World
title_sort how [18f]-fdg-pet/ct affects clinical management of patients with germ cell tumors in the real world
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10377569/
https://www.ncbi.nlm.nih.gov/pubmed/37509313
http://dx.doi.org/10.3390/cancers15143652
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