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Benefit of PET in Esophageal Cancer Not Proven

By MedImaging International staff writers
Posted on 04 Sep 2013

A new report claims that the patient benefits of positron emission tomography (PET) in esophageal cancer, either alone or in combination with computed tomography (CT), are not proven.

Researchers at the German Institute for Quality and Efficiency in Health Care (IQWiG; Köln, Germany) searched for studies that had examined the consequences of diagnostic interventions using PET or PET/CT, with regard to whether they were accompanied by perceptible improvements for patients (such as an increased of chances of survival or improved quality of life), or spared them unnecessary operations or further diagnostic interventions. The search for direct comparative intervention studies was unsuccessful, so that the question regarding the patient-relevant benefit of PET or PET/CT in esophageal cancer remains open.

The researchers also searched for studies in which the diagnostic accuracy and prognostic power of PET or PET/CT was compared with other examination methods. They found 48 studies relevant for diagnostic and prognostic accuracy, of which most examined the accuracy of primary staging. However, 19 studies directly compared PET with CT; the conclusions in favor of one or the two techniques could not be drawn, as either statistically significant difference was not shown or the data could not be interpreted with sufficient certainty. The report was published by IQWiG on August 20, 2013.

“A reliable conclusion on the diagnostic and prognostic accuracy of PET or PET/CT in restaging or recurrence diagnostics is therefore not possible,” concluded the researchers. “In particular the potential advantage of PET and PET/CT, which visualize metabolic activity, remains unclear versus morphologic imaging techniques such as CT or magnetic resonance imaging, which display anatomical structures.”

About 4,800 men and 1,400 women are newly diagnosed with esophageal cancer in Germany alone each year. The average age of disease onset is 65 years, and the 5-year survival rate is at best 20%. Many experts assume that an examination using PET or PET/CT is better able to evaluate how far a tumor has spread (staging) and whether it has responded to treatment (restaging); in addition, better detection of tumor recurrence ought to be possible.

Related Links:
German Institute for Quality and Efficiency in Health Care

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68 (185.01281738281): SELECT fid FROM jos_deeppockets WHERE id=294748077 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294748077 AND published='1' LIMIT 1

69 (!!!!! 1492.0234680176): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=213 ORDER BY `ordering`

70 (!!!!! 2761.8408203125): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294748077 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (306.12945556641): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294748077 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (67.949295043945): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

73 (76.770782470703): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (!!!!! 2449.0356445312): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (51.021575927734): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (!!!!! 1595.0202941895): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (44.107437133789): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (69.141387939453): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294748077 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (32.186508178711): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294748077 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (35.04753112793): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

90 (991.8212890625): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (41.961669921875): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (324.96452331543): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (!!!!! 4440.0691986084): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (427.0076751709): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (308.99047851562): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (830.88874816895): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (44.107437133789): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (805.85479736328): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (336.88545227051): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (!!!!! 4556.8943023682): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748077 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748077 AND published='1' LIMIT 1

105 (115.15617370605): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748077 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748077 AND published='1' LIMIT 1

106 (59.843063354492): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294748077 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (!!!!! 3445.1484680176): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294748077 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (133.99124145508): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748077 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748077 AND published='1' LIMIT 1

109 (46.014785766602): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748077 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748077 AND published='1' LIMIT 1

110 (59.127807617188): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294748077 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (609.8747253418): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294748077 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (791.07284545898): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

113 (!!!!! 2699.8519897461): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

114 (198.8410949707): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748077 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748077 AND published='1' LIMIT 1

115 (76.055526733398): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748077 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748077 AND published='1' LIMIT 1

116 (85.830688476562): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748077 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748077 AND published='1' LIMIT 1

117 (52.928924560547): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748077 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748077 AND published='1' LIMIT 1

118 (78.201293945312): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748077 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748077 AND published='1' LIMIT 1

119 (58.889389038086): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748077 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748077 AND published='1' LIMIT 1

120 (77.962875366211): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748077 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748077 AND published='1' LIMIT 1

121 (60.081481933594): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748077 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748077 AND published='1' LIMIT 1

122 (463.96255493164): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

123 (!!!!! 49691.915512085): SELECT * FROM jos_deeppockets WHERE jos_deeppockets.cat = 10 AND jos_deeppockets.type = 'deeppockets_item' AND jos_deeppockets.published = 1 AND jos_deeppockets.created + INTERVAL 14 DAY >= NOW() ORDER BY jos_deeppockets.hits DESC LIMIT 7

124 (!!!!! 2012.0143890381): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294748077 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294748077 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 21569.013595581): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

126 (128.98445129395): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

127 (783.92028808594): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1

128 (98.943710327148): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1

129 (847.10121154785): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1

130 (71.048736572266): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1

131 (411.03363037109): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

132 (288.96331787109): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

133 (766.99256896973): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1

134 (155.92575073242): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1

135 (!!!!! 1173.9730834961): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748077 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

136 (715.97099304199): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748077 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

137 (840.90232849121): SELECT name FROM jos_deeppockets WHERE id=213

138 (59.127807617188): SELECT name FROM jos_deeppockets WHERE id=213

139 (587.94021606445): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))213((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

140 (673.05564880371): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))213((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

141 (558.13789367676): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748077 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748077 AND published='1' LIMIT 1

142 (174.04556274414): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748077 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748077 AND published='1' LIMIT 1

143 (!!!!! 20643.949508667): TRUNCATE TABLE jos_trademed_module

144 (!!!!! 6520.9865570068): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294748077 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

145 (!!!!! 7913.1126403809): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294748077 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

146 (!!!!! 7683.9923858643): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748077 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

147 (!!!!! 6623.9833831787): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748077 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

148 (!!!!! 5208.0154418945): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748077 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748077 AND published='1' LIMIT 1

149 (286.10229492188): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748077 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748077 AND published='1' LIMIT 1

150 (!!!!! 2349.1382598877): SELECT jos_item.* FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id WHERE 1=1 AND (jos_item.imgMini<>'') AND jos_item.type='L' AND jos_item.numberID= ( SELECT jos_number.id FROM jos_number WHERE jos_number.journalID IN (10) and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P') ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC LIMIT 0,1 ) ORDER BY RAND() DESC LIMIT 6

151 (465.86990356445): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748077 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748077 AND published='1' LIMIT 1

152 (60.081481933594): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748077 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748077 AND published='1' LIMIT 1

153 (292.77801513672): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294748077 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294748077 AND type='deeppockets_item' AND published='1' LIMIT 1

154 (37.908554077148): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=213 or channel_id is null)

155 (106.0962677002): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=213 or channel_id is null)

156 (628.94821166992): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

157 (109.91096496582): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748077 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748077 AND published='1' LIMIT 1

158 (46.014785766602): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748077 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748077 AND published='1' LIMIT 1

159 (!!!!! 7817.9836273193): select jos_twitters.link from jos_twitters where cat=10

160 (!!!!! 8085.9661102295): select jos_facebook.link from jos_facebook where cat=10

161 (!!!!! 7786.0355377197): select jos_google_plus.link from jos_google_plus where cat=10

162 (!!!!! 7960.0811004639): select jos_linkedin.link from jos_linkedin where cat=10

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