Is ^99mTc bone scintigraphy necessary in the preoperative workup for patients with cT1N0 subsolid lung cancer? A prospective multicenter cohort study

Abstract

Background 99mTc bone scintigraphy (BS) is still the most common approach for the evaluation of bone metastasis in China. The purpose of this study was to investigate the necessity of BS as part of a routine preoperative workup for patients with cT1N0 subsolid lung cancer. Methods This was a prospective multicenter clinical trial (NCT03689439). Patients with cT1N0 subsolid nodules who were candidates for surgical resection were consecutively enrolled into the study. BS was performed preoperatively. The surgical plan could be changed if a positive result was detected. The primary endpoint was the incidence rate of the surgical plan being changed because of positive BS results. The secondary endpoint was the rate of positive BS findings and the rate of related complications. Results From November 2018 to July 2019, 691 patients were enrolled into the study. None of the patients had positive BS results and no surgical plans were changed by BS findings. There were 222 male and 469 female patients. The average age was 54.8 ± 3.7 years old. The average tumor diameter was 14.9 ± 4.2 mm. There were 282 patients with pure GGO nodules and 409 with part‐solid nodules. A total of 470 patients had a single nodule, while 221 patients had multifocal lesions. The number of patients whose pathological diagnosis was invasive adenocarcinoma, minimally invasive adenocarcinoma, adenocarcinoma in situ and mucinous adenocarcinoma was 357, 293, 32 and nine, respectively. The number of patients who underwent lobectomy, segmentectomy and wedge resection was 234, 199 and 258, respectively. Conclusions 99mTc bone scintigraphy is unnecessary in the preoperative workup for patients with cT1N0 subsolid lung cancer. Key points Significant findings of the study In this prospective study of 691 patients with cT1N0 subsolid lung cancer, no surgical plans were affected by positive bone scan findings. What this study adds We suggest physicians consider canceling BS from preoperative workup for cT1 subsolid lung cancer patients. Clinical trial registry number: NCT03689439.

99mTc bone scintigraphy does not affect preoperative workup for patients with potentially resectable esophageal squamous cell carcinoma

“…In addition, BS is still the most popular approach for detection of BM in preoperative staging in China. 8 , 9 …”

“…99m Tc bone scintigraphy (BS) is the mainstay method for the detection and evaluation of BM in various cancers at a relatively affordable cost. In addition, BS is still the most popular approach for detection of BM in preoperative staging in China 8,9 …”

“…In addition, BS is still the most popular approach for detection of BM in preoperative staging in China. 8,9 Esophageal cancer (EC), the sixth leading cause of cancer mortality in the world, is caused by complex factors as characterized by histology, population, and region. 10,11 Esophageal squamous cell carcinoma (ESCC) is one of the two most common histopathological types and prone to lymph node metastasis and distant metastasis.…”

Necessity of preoperative bone scintigraphy for cT1N0 lung cancer: Evidence from retrospective to prospective study

“…Li and colleagues have presented an interesting article on the management of preoperative bone scintigraphy (BS) for patients suspected of early‐stage lung cancer 1 . In general, bone metastases (BM) are commonly seen in patients of advanced lung cancer with an incidence that is reported as 20–40%.…”