Colorectal Cancer Clinical Trial
Official title:
The Impact of Positron Emission Tomography (PET) Imaging Prior to Liver Resection for Colorectal Adenocarcinoma Metastases: A Prospective, Multicentre Randomized Clinical Trial
The purpose of this trial is to improve the management of patients with potentially
surgically curable colorectal cancer liver metastases.
The primary objective is to determine the impact of pre-operative positron emission
tomography (PET) on patients who have been assessed as having resectable colorectal cancer
liver metastases by conventional imaging (computed tomography (CT) abdomen/thorax,
colonoscopy), by determining the proportion of patients who have a change in management
resulting from PET.
Colorectal cancer remains a leading cause of death in men and women. A significant number of
patients with colorectal cancer will either present with, or subsequently develop, liver
metastases. In contrast to many other epithelial solid tumours, resection of colorectal
cancer hepatic metastases results in long-term survival and even cure. However, despite
state of the art CT imaging, 60-75% of patients who appear to have limited disease amenable
to surgical resection will eventually die from extra-hepatic and recurrent hepatic
metastases. If occult micrometastatic disease that becomes evident after liver resection
could be detected reliably during pre-operative assessment, patients harboring more
widespread disease could be spared a non-curative liver resection. This is one of the
present challenges of liver surgery. PET imaging has the potential to improve the detection
of both hepatic and extra-hepatic metastatic disease, not detected by conventional imaging
modalities.
This prospective, multicenter trial will enroll patients with colorectal cancer liver
metastases considered resectable, based on CT scans of the thorax, abdomen and pelvis, which
demonstrate no evidence of extra-hepatic disease. A full colonoscopy within the preceding 12
months will ensure there is no local recurrence, or other primary cancer at the time of
planned liver resection. These patients will be randomized to PET scan or not.
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Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Diagnostic
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