The impact of FDG-PET/CT on the diagnostic pathway of surgically treated pancreatic ductal adenocarcinoma: the Surg-Panc-UK study.
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All Authors
McKay, SC.
Thorne, TW.
Pathak, S.
Wilkin, RJW.
Barrie, J.
Moir, J.
Roberts, KJ.
LTHT Author
Pathak, Samir
LTHT Department
Abdominal Medicine & Surgery
General Surgery
General Surgery
Non Medic
Publication Date
2025
Item Type
Journal Article
Observational Study
Observational Study
Language
Subject
Subject Headings
Abstract
BACKGROUND: In the UK, NICE recommends FDG-PET/CT (PET/CT) in patients undergoing surgery for pancreatic ductal adenocarcinoma (PDAC) though the impact upon the patient pathway is unclear and was not tested in the PETPANC study.
METHODS: National retrospective observational cohort study of consecutive patients undergoing surgery for PDAC. The primary outcome was the difference in diagnostic pathway length with and without a PET/CT. Secondary outcomes determined differences in investigations, resection rates and survival one year after surgery.
RESULTS: Of 830 patients included, 26.5% underwent PET/CT, associated with a significantly longer diagnostic pathway (median 20.5 additional days). PET/CT was associated with more multidisciplinary meetings and investigations, but did not alter resectability rates (90.3% vs 89.1%, PET/CT vs no PET/CT; p = .600), or facilitate operating on patients with more borderline disease (vascular resection 15.1% vs 13.6% PET/CT vs no PET/CT; p = .651). There was no difference in intra-operative unresectability or 12-month survival. There was an increase in MRI use after implementation of the guidelines among patients not undergoing PET/CT, suggesting teams developed different staging strategies.
CONCLUSION: This national study demonstrates patients undergoing a PET/CT experience a diagnostic pathway that is one third longer, with more investigations, without a difference in resectability rates or survival.
Journal
HPB