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Head, neck scans after cancer treatment reduce need for surgery

In addition to reducing the need for surgery by nearly two-thirds, limiting surgeries to those who need it based on scans saved more than $2,000 in treatment per patient.
By Stephen Feller   |   March 24, 2016 at 1:37 PM

BIRMINGHAM, England, March 24 (UPI) -- Positron emission tomography-computed tomography, orPET-CT, scans after chemoradiotherapy indicated a significant number of surgeries to remove cancer cells were unnecessary, according to a recent study.

The surgeries are often done to remove cancer cells remaining after treatment, but the study, conducted at several universities in England, found scanning the area can prevent the surgeries.

The procedure, a neck dissection, is a complicated three-hour surgery involving about a weeklong hospital stay that carries high rates of complication and morbidity.

In addition to preventing unneeded surgeries, the researchers report using PET-CT scans could save more than $2,000 per patient in tens of thousands of cancer cases per year around the world.

"After treatment, remaining cancer cells play something akin to 'hide and seek,'" Dr. Hisham Mehanna, from the Institute of Head and Neck Studies and Education, or InHANSE, at the University of Birmingham, explained in a press release. "Our study shows that using this PET-CT scan we can hunt them down, find them and remove them effectively."

"Patient outcomes, and avoiding unnecessary surgery, are the main goals of this study. But there is a cost saving to be made too," he added.

For the study, published in the New England Journal of Medicine, researchers recruited 564 patients at 37 cancer centers in England, 282 of whom had surgery and 282 of whom were watched using scans.

Just 19 percent of patients who were watched using PET-CT scans had surgeries, compared to 78 percent of the group planned to have them. Complication rates following surgery were about even, 42 percent in the PET-CT group, compared to 38 percent in the planned surgery group.

In addition to complications staying about even between the two groups, two-year survival was about the same, though slightly higher in the scan group than the surgical group, 84.9 percent to 81.5 percent, and quality of life was judged to be similar as well.

Avoiding surgery also saved considerable money, as using PET-CT scans rather than automatic surgery saved about $2,190 per patient during the study.

"This is an important study for the future management of these patients," said Dr. Janet Dunn, a researcher at the University of Warwick. "When we first designed the study in 2007, patients were undergoing routine neck dissection and they did not have access to PET-CT. The results show that the use of PET-CT imaging can prevent unnecessary operations and reduce associated surgical complications."

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