PURPOSE: Our objective was to determine the impact of initial (18)F-FDG PET/CT (PET/CT) staging on clinical stage and the management plan and the prognostic value of PET/CT in patients with non-small-cell lung cancer (NSCLC). METHODS: We retrospectively reviewed the records of 592 patients with NSCLC who were referred to The University of Texas MD Anderson Cancer Center during 2002/2011 and had both PET/CT and conventional CT for initial staging. Clinical stages and management plans were compared between PET/CT and CT. The impact of PET/CT on management plans was considered medium/high when PET/CT changed the planned treatment modality or treatment intent. PET/CT and CT stages were compared with all-cause mortality and survival rates. We also assessed potential prognostic factors for progression-free survival (PFS) and overall survival (OS). RESULTS: PET/CT changed the stage in 170 patients (28.7 %; 16.4 % upstaged, 12.3 % downstaged). PET/CT had a medium/high impact on the management plan in 220 patients (37.2 %). PFS and OS were significantly worse in patients with upstaged disease than in patients with no change in stage (median PFS 29.0 vs. 53.8 months, P < 0.001; median OS:64.7 vs. 115.9 months, P = 0.006). PFS and OS were significantly worse in patients with medium/high impact of PET/CT than in patients with no/low impact of PET/CT (median PFS 24.7 vs. 60.6 months, P < 0.001; median OS 64.7 vs. 115.9 months, P < 0.001). In multivariate analysis, a medium/high impact of PET/CT was an independent predictor of worse PFS (hazard ratio, HR, 1.73; 95 % CI 1.30 - 2.29; P = 0.0002) and OS (HR 1.84; 95 % CI 1.26 - 2.69; P = 0.002). CONCLUSION: Initial PET/CT staging not only impacts stage and management plan but also has prognostic value.
PURPOSE: Our objective was to determine the impact of initial (18)F-FDG PET/CT (PET/CT) staging on clinical stage and the management plan and the prognostic value of PET/CT in patients with non-small-cell lung cancer (NSCLC). METHODS: We retrospectively reviewed the records of 592 patients with NSCLC who were referred to The University of Texas MD Anderson Cancer Center during 2002/2011 and had both PET/CT and conventional CT for initial staging. Clinical stages and management plans were compared between PET/CT and CT. The impact of PET/CT on management plans was considered medium/high when PET/CT changed the planned treatment modality or treatment intent. PET/CT and CT stages were compared with all-cause mortality and survival rates. We also assessed potential prognostic factors for progression-free survival (PFS) and overall survival (OS). RESULTS: PET/CT changed the stage in 170 patients (28.7 %; 16.4 % upstaged, 12.3 % downstaged). PET/CT had a medium/high impact on the management plan in 220 patients (37.2 %). PFS and OS were significantly worse in patients with upstaged disease than in patients with no change in stage (median PFS 29.0 vs. 53.8 months, P < 0.001; median OS:64.7 vs. 115.9 months, P = 0.006). PFS and OS were significantly worse in patients with medium/high impact of PET/CT than in patients with no/low impact of PET/CT (median PFS 24.7 vs. 60.6 months, P < 0.001; median OS 64.7 vs. 115.9 months, P < 0.001). In multivariate analysis, a medium/high impact of PET/CT was an independent predictor of worse PFS (hazard ratio, HR, 1.73; 95 % CI 1.30 - 2.29; P = 0.0002) and OS (HR 1.84; 95 % CI 1.26 - 2.69; P = 0.002). CONCLUSION: Initial PET/CT staging not only impacts stage and management plan but also has prognostic value.
Authors: David G Pfister; David H Johnson; Christopher G Azzoli; William Sause; Thomas J Smith; Sherman Baker; Jemi Olak; Diane Stover; John R Strawn; Andrew T Turrisi; Mark R Somerfield Journal: J Clin Oncol Date: 2003-12-22 Impact factor: 44.544
Authors: Jonas Schreyögg; Julia Weller; Tom Stargardt; Ken Herrmann; Christina Bluemel; Tobias Dechow; Gerhard Glatting; Bernd J Krause; Felix Mottaghy; Sven N Reske; Andreas K Buck Journal: J Nucl Med Date: 2010-11 Impact factor: 10.057
Authors: Carolyn E Reed; David H Harpole; Katherine E Posther; Sandra L Woolson; Robert J Downey; Bryan F Meyers; Robert T Heelan; Homer A MacApinlac; Sin-Ho Jung; Gerard A Silvestri; Barry A Siegel; Valerie W Rusch Journal: J Thorac Cardiovasc Surg Date: 2003-12 Impact factor: 5.209
Authors: J F Vansteenkiste; S G Stroobants; P R De Leyn; P J Dupont; J Bogaert; A Maes; G J Deneffe; K L Nackaerts; J A Verschakelen; T E Lerut; L A Mortelmans; M G Demedts Journal: J Clin Oncol Date: 1998-06 Impact factor: 44.544
Authors: F Arias; V Chicata; M J García-Velloso; G Asín; M Uzcanga; C Eito; I Quilez; A Viudez; J Saenz; I Hernández; C Caicedo; M Errasti; M Barrado; F García-Bragado Journal: Clin Transl Oncol Date: 2014-07-31 Impact factor: 3.405
Authors: Carlos Caicedo; Maria Jose Garcia-Velloso; Maria Dolores Lozano; Tania Labiano; Carmen Vigil Diaz; Jose Maria Lopez-Picazo; Alfonso Gurpide; Javier J Zulueta; Javier Zulueta; Jose Angel Richter Echevarria; Jose Luis Perez Gracia Journal: Eur J Nucl Med Mol Imaging Date: 2014-07-03 Impact factor: 9.236