Frequency of extrathoracic metastases from bronchogenic carcinoma in patients with normal-sized hilar and mediastinal lymph nodes on CT

Sider, Lee; Horejs, D

doi:10.2214/ajr.151.5.893

Cited by 52 publications

(26 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…If clinical examination is positive for metastatic disease then metastases will be found by imaging in y50% of patients. SIDER and HOREJS [114], found extrathoracic metastases in 25% of patients with stage I disease at thoracic CT, brain 11%, bone 8%, liver 6% and adrenals 6% (some patients having more than one site of metastatic spread). Clinically occult metastases were present in only 4% of patients.…”

Section: Metastatic Statusmentioning

confidence: 95%

Diagnostic imaging of lung cancer

Hollings¹,

Shaw²

2002

Eur Respir J

124

View full text Add to dashboard Cite

Carcinoma of the bronchus is the most common malignancy in the Western world. It is also the leading cause of cancer-related death accounting for 32% of all cancer deaths in males and 25% in females [1]. In the USA it causes more deaths than cancers of the colon, breast and prostate combined [2]. Disappointingly, in a recent UK survey of improvements in cancer survival [3], carcinoma of the bronchus showed the smallest percentage reduction in the number of deaths avoided between 1981-1990 (0.2%). This compares badly with breast (11% reduction) and melanoma (32%). The overall 5-yr survival for lung cancer diagnosed between 1986-1990 was only 5.3% (against 66% for breast and 76% for melanoma). It is on this background that the radiologist remains actively employed in the detection, diagnosis, staging and review of this common malignancy.

show abstract

Section: Metastatic Statusmentioning

confidence: 95%

Diagnostic imaging of lung cancer

Hollings¹,

Shaw²

2002

Eur Respir J

124

View full text Add to dashboard Cite

show abstract

“…In their study on 95 patients who had operable disease on chest CT, Sider et al found bone metastases in 8 patients (21). Thus the authors suggested that even with a CT showing no mediastinal involvement, it is worthwhile to rule out extra thoracic spread.…”

Section: Discussionmentioning

confidence: 97%

Pediatric "Off-Label" Prescribing: What Every APN Should Know

1999

IJANP

View full text Add to dashboard Cite

Study objectives: The management of patients diagnosed with non-small cell lung cancer is dependant on the stage of disease, which is also crucial for prognosis and selection of an appropriate treatment regimen. Historically a whole body bone scan has been used to identify skeletal metastases. The aim of this study was to investigate the usefulness of whole-body bone scanning (BS) in detecting bone metastases in newly diagnosed and apparently operable cases of lung cancer. Design and patients: Ninety two patients with a diagnosis made between 2008 and 2010 were recruited (squamous cell carcinoma, n =29; adenocarcinoma, n=36 ; non-small cell carcinoma, n= 22; others n=5). None of these patients had clinical factors suggesting bone metastasis (skeletal pain, elevated alkaline phosphatase, hypercalcemia). BS was performed in all patients, and additional imaging or biopsy was ordered in patients where there were doubtful lesions. Measurements and results: Bone metastases were detected in 14.13 % (n =13 ) of 92 clinical factor-negative patients. Of the eighteen abnormal bone scan results (eleven positive and seven probable), thirteen were true-positive and the five remaining were false-positive. In our study, PPV of the BS was 72.2%. Skeletal metastases was found more commonly in adenocarcinoma (46.15%, n=6 ) than other cell types. In 13 patients diagnosed with metastases, 53.8 % (n=7) were patients with non-small cell lung cancer and 38.4% (n=5) with small cell lung cancer. 4 of the 18 patients (22.2%) in T2N0M0 clinical stage had bone metastases. The routine bone scanning prevented thirteen futile thoracotomies (14%) in 92 patients with apparently operable lung cancer. Conclusions: Though clinical factors have a high NPV and the bone scans have less than desired specificity in diagnosing metastases, BS could be considered in those asymptomatic patients as a part of their work up and staging, in whom operative intervention is contemplated.

show abstract

“…SIDER et al [87] demonstrated CT evidence of extrathoracic tumour spread in 24 of 95 (25%) patients with newly diagnosed nonsmall cell lung cancer and N0 disease at thoracic CT. These included metastases to the brain, bone, liver, adrenals and soft tissue.…”

Section: Evaluation Of Distant Metastasis: the M Factormentioning

confidence: 99%

Computed tomography in staging for lung cancer

Verschakelen¹,

Bogaert²,

Wever³

2002

Eur Respir J

View full text Add to dashboard Cite

Computed tomography (CT) provides the most detailed imaging information, hence it is generally used as a routine imaging procedure in the tumour, node, metastasis (TNM)-staging of patients with lung cancer. However, despite the continuously ongoing process of improvement in CT scanning in which today9s CT scanners combine fast acquisition, fast data reconstruction and high detail, the technique has important limitations.CT can, in some cases, very accurately show tumour extent within, and predict spread beyond the lung. However, the question of whether the tumour has invaded the chest wall or the mediastinum and, if so, whether it is still potentially surgically curable often remains unanswered. In addition, the only sign for predicting lymph node involvement using CT is enlargement. Many studies have shown that this sign is not very reliable. CT is also, with success, being used to evaluate distant metastases although other techniques such as ultrasound and magnetic resonance imaging can have similar or higher accuracies.Despite these well-known limitations, computed tomography will most likely stay the routine imaging procedure for determining resectability and for assessing intra-and extrathoracic spread of lung cancer. The improvement in technology will probably result a better T-staging. The role of computed tomography in nodal staging remains important. It offers the surgeon a road map of the lymph nodes and guides towards the nodes that need biopsy. Combining computed tomography with positron emission tomography, when it becomes more widely available, will add functional images to the detail of computed tomography and will not only improve nodal staging but will probably also allow a better evaluation of distant metastasis and reduce the number of unnecessary interventional procedures.

show abstract

Frequency of extrathoracic metastases from bronchogenic carcinoma in patients with normal-sized hilar and mediastinal lymph nodes on CT

Cited by 52 publications

References 13 publications

Diagnostic imaging of lung cancer

Diagnostic imaging of lung cancer

Pediatric "Off-Label" Prescribing: What Every APN Should Know

Computed tomography in staging for lung cancer

Contact Info

Product

Resources

About