Prospective Comparative Study of Integrated Positron Emission Tomography-Computed Tomography Scan Compared With Remediastinoscopy in the Assessment of Residual Mediastinal Lymph Node Disease After Induction Chemotherapy for Mediastinoscopy-Proven Stage IIIA-N2 Non–Small-Cell Lung Cancer: A Leuven Lung Cancer Group Study

Leyn, Paul De; Stroobants, Sigrid; Wever, Walter De; Lerut, Toni; Coosemans, Willy; Decker, G. Anton; Nafteux, Philippe; Raemdonck, Dirk Van; Mortelmans, Luc; Nackaerts, Kristiaan; Vansteenkiste, Johan

doi:10.1200/jco.2006.05.6341

Cited by 226 publications

(174 citation statements)

References 31 publications

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“…In this setting, PET/CT was more accurate than remediastinoscopy (83% versus 60%; p,0.05) and significantly more accurate than PET or CT alone. The reason for the low sensitivity of remediastinoscopy can be found in post-treatment alterations, such as adhesions and fibrosis, that rendered, especially, the subcarinal space inaccessible [60].…”

Section: Mediastinal Restagingmentioning

confidence: 99%

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Integrated PET/CT in the staging of nonsmall cell lung cancer: technical aspects and clinical integration

Wever

Stroobants²,

Coolen³

et al. 2008

Eur Respir J

107

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Lung cancer is a common disease and is a leading cause of death in many countries. The management of lung cancer is directed by an optimal staging of the tumour. Integrated positron emission tomography (PET)/computed tomography (CT) is an anatomo-metabolic imaging modality that has recently been introduced to clinical practice and combines two different techniques: CT, which provides very detailed anatomic information; and PET, which provides metabolic information. One of the advantages of PET/CT is the improved image interpretation. This improvement can result in the detection of lesions initially not seen on CT or PET, a more precise location of lesions, a better characterisation of the lesion as benign or malignant and a better differentiation between tumour and surrounding structures. Initial studies demonstrate better results for PET/CT in the staging of lung cancer in comparison with PET alone, CT alone or visual correlation of PET and CT. The purpose of the present article is to discuss technical aspects of integrated PET/CT and to attempt to outline how to introduce integrated PET/ CT in clinical and daily practice.

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Section: Mediastinal Restagingmentioning

confidence: 99%

“…Furthermore, the results of remediastinoscopy are disappointing. DE LEYN et al [60] have investigated this issue prospectively in 30 patients with stage IIIA N2 lung cancer. They used surgical findings as the gold standard for comparing the accuracy of PET/CT for N-staging with that of remediastinoscopy after neoadjuvant therapy.…”

Section: Mediastinal Restagingmentioning

confidence: 99%

Integrated PET/CT in the staging of nonsmall cell lung cancer: technical aspects and clinical integration

Wever

Stroobants²,

Coolen³

et al. 2008

Eur Respir J

107

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show abstract

“…[15,16] However, reliance on imaging alone is unacceptable and tissue diagnosis is still required to guide management. [17,18] Therefore, re-mediastinal staging after induction therapy is necessary for selecting the appropriate treatment strategy, but redo mediastinoscopy after induction therapy may be inaccurate. [19] The first mediastinoscopy might cause local fibrosis and adhesions, which make it technically difficult to perform re-mediastinoscopy.…”

Section: Discussionmentioning

confidence: 99%

Should transbronchial needle aspiration and rapid on-site cytologic evaluation be performed before mediastinoscopy? “Analysis of 239 cases”

Cangır¹

2016

Turk Gogus Kalp Dama

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“…Respective values for PET scan were 63%, 70%, 26% and 34%. Combined PET-CT seems more adequate, with sensitivity of 62-77%, specificity of 88-92%, false-negative rate of 20-25%, false-positive rate of 7-25%, and an accuracy of 79-83% [106,107]. Few studies have assessed the role of minimally invasive procedures for mediastinal re-staging.…”

Section: Statementmentioning

confidence: 99%

Surrogate markers predicting overall survival for lung cancer: ELCWP recommendations

Berghmans¹,

Pasleau²,

Paesmans³

et al. 2011

Eur Respir J

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The present systematic review was performed under the auspices of the European Lung Cancer Working Party (ELCWP) in order to determine the role of early intermediate criteria (surrogate markers), instead of survival, in determining treatment efficacy in patients with lung cancer. Initially, the level of evidence for the use of overall survival to evaluate treatment efficacy was reviewed. Nine questions were then formulated by the ELCWP. After reviewing the literature with experts on these questions, it can be concluded that overall survival is still the best criterion for predicting treatment efficacy in lung cancer. Some intermediate criteria can be early predictors, if not surrogates, for survival, despite limitations in their potential application: these include time to progression, progression-free survival, objective response, local control after radiotherapy, downstaging in locally advanced nonsmall cell lung cancer (NSCLC), complete resection and pathological TNM in resected NSCLC, and a few circulating markers. Other criteria assessed in these recommendations are not currently adequate surrogates of survival in lung cancer.

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Abstract: After a thorough staging mediastinoscopy, postinduction remediastinoscopy had a disappointing sensitivity because of adhesions and fibrosis. Integrated PET-CT yielded a better result than that obtained in previous studies with side-by-side PET and CT images.

Cited by 226 publications

References 31 publications

Integrated PET/CT in the staging of nonsmall cell lung cancer: technical aspects and clinical integration

Integrated PET/CT in the staging of nonsmall cell lung cancer: technical aspects and clinical integration

Should transbronchial needle aspiration and rapid on-site cytologic evaluation be performed before mediastinoscopy? “Analysis of 239 cases”

Surrogate markers predicting overall survival for lung cancer: ELCWP recommendations

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