Follow-up of local (stage I and stage II) non-small-cell lung cancer after surgical resection

Edelman, Martin J.; Schuetz, Julie

doi:10.1007/s11864-002-0043-y

Cited by 10 publications

(5 citation statements)

References 34 publications

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“…There are no convincing data supporting that early detection of progression with chest X-ray or CT scan improves survival. 82,[124][125][126] This might be different for FDG-PET scanning, as PET is more accurate than CT in the distinction of tumor from post-RT effects 109,114,127 , and is known to be prognostic for outcome. 87,93,[128][129][130] A prospective study was performed to evaluate whether PET-CT 3 months after therapy can detect potentially curable progression in locally advanced NSCLC 131 , which was the case in a small proportion (3%) of patients, who were all asymptomatic.…”

Section: Added Value Of Pet After Combined Modality Treatmentmentioning

confidence: 99%

Therapeutic implications of molecular imaging with PET in the combined modality treatment of lung cancer

Loon

Baardwijk

Boersma

et al. 2011

Cancer Treatment Reviews

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Molecular imaging with PET, and certainly integrated PET-CT, combining functional and anatomical imaging, has many potential advantages over anatomical imaging alone in the combined modality treatment of lung cancer. The aim of the current article is to review the available evidence regarding PET with FDG and other tracers in the combined modality treatment of locally advanced lung cancer. The following topics are addressed: tumor volume definition, outcome prediction and the added value of PET after therapy, and finally its clinical implications and future perspectives. The additional value of FDG-PET in defining the primary tumor volume has been established, mainly in regions with atelectasis or post-treatment effects. Selective nodal irradiation (SNI) of FDG-PET positive nodal stations is the preferred treatment in NSCLC, being safe and leading to decreased normal tissue exposure, providing opportunities for dose escalation. First results in SCLC show similar results. FDG-uptake on the pre-treatment PET scan is of prognostic value. Data on the value of pre-treatment FDG-uptake to predict response to combined modality treatment are conflicting, but the limited data regarding early metabolic response during treatment do show predictive value. The FDG response after radical treatment is of prognostic significance. FDG-PET in the follow-up has potential benefit in NSCLC, while data in SCLC are lacking. Radiotherapy boosting of radioresistant areas identified with FDG-PET is subject of current research. Tracers other than (18)FDG are promising for treatment response assessment and the visualization of intra-tumor heterogeneity, but more research is needed before they can be clinically implemented.

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Section: Added Value Of Pet After Combined Modality Treatmentmentioning

confidence: 99%

Therapeutic implications of molecular imaging with PET in the combined modality treatment of lung cancer

Loon

Baardwijk

Boersma

et al. 2011

Cancer Treatment Reviews

View full text Add to dashboard Cite

show abstract

“…However, current single-institution studies of routine surveillance after curative-intent surgery have shown a reduction in the lag time for diagnosis of recurrence without a meaningful improvement in overall or lung cancer-specific survival (11,(18)(19)(20)(21).…”

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confidence: 99%

Pattern of Imaging after Lung Cancer Resection. 1992–2005

Sharma

Nishi²,

Lin

et al. 2016

Annals ATS

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Rationale: Imaging intensity after lung cancer resection performed with curative intent is unknown.Objectives: To describe the pattern and trends in the use of computed tomography (CT) and positron emission tomography (PET) scans in patients after resection of early-stage lung cancer. Measurements and Main Results: Overall, imaging use was higher within the first 2 years versus Years 3-5 after surgical resection. Use of surveillance CT scans increased sharply from 13.7 to 57.3% of those diagnosed in 1996-1997 and 2004-2005, respectively. PET scan use increased threefold, from 6.2% in 2000-2001 to 19.6% in 2004-2005. In multivariable analyses, we observed a 32% increase in the odds of undergoing surveillance CT or PET imaging for every year of diagnosis between 1998 and 2005. There was no substantial decline in the odds of having a surveillance CT or PET scan during each successive follow-up period, suggesting no change in the intensity of surveillance over the first 5 years after surgical resection. The proportion of surveillance CT imaging performed at freestanding imaging centers increased from 18.0% in 1998-1999 to 30.6% in 2004-2005. Methods Conclusions:The use of CT and PET imaging for surveillance after curative-intent surgical resection of early-stage lung cancer increased sharply in the United States between 1997-1998 and 2005. In the absence of evidence demonstrating favorable outcomes, this practice was likely driven by prevailing expert opinion embedded in clinical practice guidelines made available during that time. Research is clearly needed to determine the role and optimal approach to surveillance thoracic imaging after surgical resection of lung cancer.

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“…In general, postoperative imaging evaluation is recommended to occur more frequently in the first 2 years after surgery, when recurrence risk is felt to be greatest. Whether these surveillance strategies have translated into meaningful improvements in lung cancer specific oncologic outcomes remains controversial (7,(12)(13)(14)(15).…”

Section: Original Articlementioning

confidence: 99%

Barriers to surveillance imaging adherence in early-staged lung cancer

Bostock¹,

Hofstetter²,

Mehran³

et al. 2021

J Thorac Dis

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Background: Frequency of post-treatment surveillance is highly variable following curative resection of non-small cell lung cancer (NSCLC). We sought to characterize surveillance practices after lobectomy for early-stage NSCLC and to identify the impact of various demographic factors on patterns of surveillance. Methods: We included patients who underwent anatomic lobectomy for pathologic stage I NSCLC from 2007-2017. Demographic characteristics, post-operative imaging studies (internal and external), and travel distance were recorded. We defined the minimal standard of surveillance imaging studies (MSSIS) as ≥7 studies in the first 5 years (computed tomography/positron emission tomography). Patient sex, ethnicity, marital status, and distance traveled were evaluated as predictors of imaging receipt. Standard descriptive statistics, univariate, and multivariate analysis (MVR) were performed. Results: A total of 1,288 patients were included. The mean age was 65.5±10.1 years, 589 (45.7%) were male, 1,081 (83.9%) were Caucasian, and 924 (71.7%) were married. Only 464 (36%) achieved MSSIS;being married [75.6% (351/464) vs. 68.8% (567/824), P=0.01] and having larger tumor size (2.63±0.04 vs.2.49±0.05 cm, P=0.03) were both associated with MSSIS. Patients residing <100 miles from the hospital were more likely to have MSSIS, and more imaging at 24 months (4.1±2.2 vs. 3.7±2.0; P=0.006), 60 months (8.0±5.1 vs. 6.6±4.2, P=0.001) and overall (10±7.3 vs. 8.2±6.3; P=0.001). On MVR, tumor size and marital status were associated with MSSIS. Conclusions: Two-thirds of patients at our institution did not undergo recommended surveillance imaging. Tumor size, being married, and living <100 miles from the medical center were associated with an increased number of imaging studies and greater adherence to guidelines.

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Follow-up of local (stage I and stage II) non-small-cell lung cancer after surgical resection

Cited by 10 publications

References 34 publications

Therapeutic implications of molecular imaging with PET in the combined modality treatment of lung cancer

Therapeutic implications of molecular imaging with PET in the combined modality treatment of lung cancer

Pattern of Imaging after Lung Cancer Resection. 1992–2005

Barriers to surveillance imaging adherence in early-staged lung cancer

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