Utility of 18 FDG-PET scan in stage 1a non small cell lung cancer (NSCLC)
V. S. Sreeguru Lakshman, K. Mohan, H. Burhan, A. Ponnuswamy, J. Greenwood, M. Ledson, M. Walshaw (Liverpool, United Kingdom)
Source: Annual Congress 2009 - Epidemiology and management of lung cancer
Session: Epidemiology and management of lung cancer
Session type: E-Communication Session
Number: 4693
Disease area: Thoracic oncology
Abstract Introduction PET scan has radically modified the diagnostic and staging process in NSCLC. However it‘s utility in staging early lung cancer (stage IA) is less clear.Methods We looked at 96 consecutive patients (mean age 70, range 24-91) who underwent PET scan for suspected & proven stage IA NSCLC over a period of 3 years.Results PET was negative in 32/96 patients: 7 lesions resolved, 1 reduced in size and 21 remain under CT follow up. In the remaining 3, the lesions increased in size and at resection stage IA adenocarcinoma, rheumatoid nodule and hamartoma was confirmed. In 1 patient PET suggested an increased uptake in the left supraclavicular fossa, which proved to be goitre at biopsy. In 53/64 patients, PET was in agreement with the CT (stage IA). 16 did not have surgery (7 declined, 9 deemed unfit) and 37 underwent resection (34 cancer; 3 benign). The pathological staging was in agreement with the PET in 28, but in 6 pathological staging was stage IB(1), IIA(3), IIB(1) and IIIA(1). PET revealed nodal disease or metastases in the remaining 11/64 patients. Of these PET resulted in false positive staging in 4, which were confirmed by histology (goitre and inflammatory node in mediastinum) and radiological follow up (PET suggested lung and nodal metastases) in 2 patients each. In the remaining 7 patients, PET upstaged the disease to IB - IIA(4), IIIA(1) and stage IV(2). This was proved in 3 cases and could not be confirmed in the remainder due to poor performance status, which also precluded surgery.Conclusion PET scan did not result in useful staging information in stage IA NSCLC. However, PET did have a useful role in diagnosis; 29 patients with a negative PET were saved unnecessary thoracotomies.
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V. S. Sreeguru Lakshman, K. Mohan, H. Burhan, A. Ponnuswamy, J. Greenwood, M. Ledson, M. Walshaw (Liverpool, United Kingdom). Utility of 18 FDG-PET scan in stage 1a non small cell lung cancer (NSCLC). Eur Respir J 2009; 34: Suppl. 53, 4693
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