PET Scan 18 F-Fluorodeoxyglucose Uptake and Prognosis in Patients With Resected Clinical Stage IA Non-small Cell Lung Cancer

Nair, Viswam S.; Barnett, Paul G.; Ananth, Lakshmi; Gould, Michael K.

doi:10.1378/chest.09-2356

Cited by 63 publications

(27 citation statements)

References 27 publications

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“…A correlation between pre-operative FDG uptake, pathological stage, probability of nodal metastasis and outcomes has also been reported for the spectrum of adenocarcinoma associated with focal GGOs and for stage I NSCLC in general [43,61,[68][69][70][71].…”

Section: Fdg Uptakementioning

confidence: 74%

Slow-growing lung cancer as an emerging entity: from screening to clinical management

et al. 2013

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The current paradigm is that untreated lung cancer is invariably and rapidly fatal, therefore the medical community normally dismisses the idea that a patient could live with such a disease for years without any therapy.Yet evidence from lung cancer screening research and from recent clinical series suggests that, although rarely recognised in routine practice, slow-growing lung cancers do exist and are more common than previously thought.Here, current evidence is reviewed and clinical cases are illustrated to show that slow-growing lung cancer is a real clinical entity, and the reasons why management protocols developed in the screening setting may also be useful in clinical practice are discussed. Features suggesting that a lung cancer may be slow-growing are described and appraised, areas of uncertainty are examined, modern management options for earlystage disease are evaluated and the influence that all this knowledge might have on our clinical decisionmaking is weighed. Further research directed at developing appropriate guidelines for these peculiar but increasingly common patients is warranted. @ERSpublications The increasingly common incidence of slow-growing lung cancer and its influence on clinical decision-making is discussed

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Section: Fdg Uptakementioning

confidence: 74%

Slow-growing lung cancer as an emerging entity: from screening to clinical management

et al. 2013

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“…Pure BAC tumors clearly have a better prognosis according to previous reports. 7,[11][12][13][14] The prognosis of mixed type tumors, with both BAC and solid components, is worse than that of pure BAC type tumors and is associated with SUVmax. This indicates that, in small adenocarcinomas, which include BAC components, the prognosis might depend on the histological subtype.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Impact of FDG-PET in Surgically Treated Pathological Stage I Lung Adenocarcinoma

Higuchi

Hasegawa

Osugi

et al. 2014

ATCS

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Purpose: This retrospective study evaluated whether the maximum standardized uptake value (SUVmax) on 18F-deoxyglucose (FDG)-positron emission tomography (PET) could be used to predict the prognosis of patients with pathological stage I adenocarcinoma. Methods: We analyzed 138 consecutive patients with pathological stage IA or IB lung adenocarcinoma except pure bronchioloalveolar carcinoma (BAC) who underwent preoperative FDG-PET imaging and curative resection from January 2005 to October 2010. We analyzed associations between disease-free survival (DFS) and clinicopathological factors. Results: The 5-year DFS rate was 77.7%. Twenty two patients (15.9%) developed recurrence after surgery. Multivariate analysis identified SUVmax and lymphovascular (ly) involvement as the independent prognostic factors for recurrence (p = 0.0255 and p = 0.0333, respectively). We divided the patients into groups according to SUVmax and ly involvement. The 5-year DFS rate was 97.0% in patients with SUVmax ≤2.5 and without ly involvement, 100% with both SUVmax ≤2.5 and ly involvement, 70.2% with SUVmax >2.5 and without ly involvement, and 53.1% with both SUVmax >2.5 and ly involvement. Conclusions: The results of this study suggest that SUVmax and ly involvement could be used to predict the prognosis of patients with pathological stage I adenocarcinoma. The combination of these prognostic factors could also identify high risk groups of recurrence.

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“…57 Among patients with indeterminate nodules (by CT scan) and high pretest probability, negative PET scan results do not reliably exclude malignancy. However, FDG uptake in the primary tumor has been shown to be inversely correlated with survival, 58,59 and patients with nonhypermetabolic malignant tumors may have a favorable prognosis, even when defi nitive surgical treatment is delayed by a period of observation as long as 238 days. 60,61 Hence, patients with solid nodules and negative (nonhypermetabolic) PET scan results are believed to require continued surveillance for at least 2 years to confi rm benignity.…”

Section: Shared Decision-making and Patient Preferencesmentioning

confidence: 99%

Evaluation of Individuals With Pulmonary Nodules: When Is It Lung Cancer?

Gould

Donington

Lynch

et al. 2013

Chest

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1,165

1,089

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we suggest that no additional diagnostic evaluation need be performed (Grade 2C) .Remark : This recommendation applies only to solid nodules. For guidance about follow-up of subsolid nodules, see Recommendations 6.5.1 to 6.5.4 . 2.3.3.In the individual with an indeterminate nodule that is identifi ed by chest radiography, we recommend that CT of the chest should be performed (preferably with thin sections Objectives: The objective of this article is to update previous evidence-based recommendations for evaluation and management of individuals with solid pulmonary nodules and to generate new recommendations for those with nonsolid nodules. Methods: We updated prior literature reviews, synthesized evidence, and formulated recommendations by using the methods described in the "Methodology for Development of Guidelines for Lung Cancer" in the American College of Chest Physicians Lung Cancer Guidelines, 3rd ed. Results: We formulated recommendations for evaluating solid pulmonary nodules that measure . 8 mm in diameter, solid nodules that measure Յ 8 mm in diameter, and subsolid nodules. The recommendations stress the value of assessing the probability of malignancy, the utility of imaging tests, the need to weigh the benefi ts and harms of different management strategies (nonsurgical biopsy, surgical resection, and surveillance with chest CT imaging), and the importance of eliciting patient preferences. Conclusions: Individuals with pulmonary nodules should be evaluated and managed by estimating the probability of malignancy, performing imaging tests to better characterize the lesions, evaluating the risks associated with various management alternatives, and eliciting their preferences for management. CHEST 2013; 143(5)(Suppl):e93S-e120SAbbreviations: AAH 5 atypical adenomatous hyperplasia; ACCP 5 American College of Chest Physicians; AIS 5 adenocarcinoma in situ; EBUS 5 endobronchial ultrasound; ENB 5 electromagnetic navigation bronchoscopy; FDG 5 fl uorodeoxyglucose; HU 5 Hounsfi eld unit; LR 5 likelihood ratio; SPECT 5 single-photon emission CT; TBB 5 transbronchial biopsy; TTNB 5 transthoracic needle biopsy; VATS 5 video-assisted thoracic surgery; VBN 5 virtual bronchoscopy navigation; VDT 5 volume doubling time

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PET Scan 18 F-Fluorodeoxyglucose Uptake and Prognosis in Patients With Resected Clinical Stage IA Non-small Cell Lung Cancer

Cited by 63 publications

References 27 publications

Slow-growing lung cancer as an emerging entity: from screening to clinical management

Slow-growing lung cancer as an emerging entity: from screening to clinical management

Prognostic Impact of FDG-PET in Surgically Treated Pathological Stage I Lung Adenocarcinoma

Evaluation of Individuals With Pulmonary Nodules: When Is It Lung Cancer?

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