Source: Annual Congress 2002 - Oncology imaging: CT, MRI and PET
Disease area: Thoracic oncology

Abstract

Previous studies have compared MR with other staging methods for lung cancer, but not with survival. Using death certificates and medical records, we reviewed 50 patients 84 - 110 (mean 100) months after surgery for lung cancer (judged potentially resectable by computerised tomography) and compared survival with previous surgical and MR staging. The MR scans were performed 0 - 15 (mean 1) days before surgery and the MR results were not known to the surgeons.49 patients were traced. Survival was significantly correlated with both MR staging (Spearman's r= -0.50; p < 0.001; n=49) and surgical staging (r= -0.54; p < 0.001; n=49). However the correlation between the two staging methods was stronger (r= 0.80; p< 0.01; n=50). Excluding the 5 non-cancer deaths and grouping the tumour stages into 3 categories - operable (I + II; n = 26/25, surgical/MRI staging), borderline (IIIa; n = 11/8) and inoperable (IIIb + IV; n = 7/11) - there was 84% agreement (37/44) between the 2 staging methods. In those 37 patients in whom the staging methods agreed 5 year survival was 13/23 (57%) for stages I + II, 0/7 for IIIa and 0/7 for IIIb + IV, with two deaths at73 and 95 months. Disagreement between the staging methods occurred in 7 patients. Of the 3 staged operable by surgery, MRI staged 2 as borderline (IIIa), one of whom was alive at 98 months, and one as inoperable (IIIb), a patient who died at 10 months. Of the remaining 4, judged borderline by surgical staging, MRI staged 3 inoperable ( none of whom survived > 15 months) and one operable ( who survived 54 months). Excluding non-cancer deaths, all who survived > 4 years were staged I or II by MR, except one longterm survivor who was staged IIIa by MR and I by surgery. No patient judged inoperable by MR ( stages IIIb or IV) survived beyond 24 months.

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Citations should be made in the following way:
A. H. Al-Ghamdi, J. R. Catterall, K. L. Bale, G. Laszlo, C. Forrester-Wood, P. Goddard (United Kingdom). 100 month survival of patients treated surgically for lung cancer: predictive value of magnetic resonance (MR) staging. Eur Respir J 2002; 20: Suppl. 38, 3768

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