Critical appraisal:Barber TW, Duong CP, Leong T, Bressel M, Drummond EG, Hicks RJ 2012

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Critical Appraisal

Article being appraised

Barber TW, Duong CP, Leong T, Bressel M, Drummond EG, Hicks RJ. 18F-FDG PET/CT has a high impact on patient management and provides powerful prognostic stratification in the primary staging of esophageal cancer: a prospective study with mature survival data. J Nucl Med 2012 Jun;53(6):864-71 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/22582047.


Applicable clinical question

Key Facts

Study Design

case series

Number of Patients:

139


Includes an economic evaluation

no

Evidence ratings

Level of evidence

IV

Risk of bias
High risk of bias Comments: This is a prospective case-series of 139 consecutive patients with biopsy proven esophageal cancer undergoing PET/CT for primary staging. The aim of this study is to evaluate the incremental staging information, management impact, and prognostic stratification of PET/CT compared to conventional staging investigations including CT and EUS in selected patients.

Risk of bias assessment: case series

Subject selection:
Highly selected or not described (e.g. single-institution study)
Were the outcome measures blind to pre/post-intervention?
No, but objective measures used
Follow-up complete and all patients included in the analysis?
Yes (follow-up >95%)
Size of effect
1 Reason for decision: Post-PET/CT stage group and treatment intent were both strongly associated with survival (P<0.001).
Relevance of evidence
2 Additional comments: This study showed that PET/CT changed the stage group in 40% patients and changed management in 34% patients compared with conventional staging investigations.
Result of appraisal

Jutta's tick icon.png Included


Reason for decision

Participants in this studies had the desired disease but were not early stage oesophageal cancer.


Completed by

Dr Jeremy Dwyer MBBS (Hons)


Jutta's tick icon.png This appraisal has been completed.


Article
Barber TW, Duong CP, Leong T, Bressel M, Drummond EG, Hicks RJ. 18F-FDG PET/CT has a high impact on patient management and provides powerful prognostic stratification in the primary staging of esophageal cancer: a prospective study with mature survival data. J Nucl Med 2012 Jun;53(6):864-71 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/22582047.
Assigned to
User:Alan.moss
Topic area
Guidelines:Barrett's
Clinical question
Form
Form:Critical appraisal


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