Allen J. Blaivas, DO
Is positron-emission tomography plus computed tomography (PET-CT) better than conventional methods for preoperative staging of non–small-cell lung cancer (NSCLC)?
Randomized controlled trial. ClinicalTrials.gov NCT00867412.
≥ 12 months (mean 27 mo).
3 pulmonology departments in or near Copenhagen, Denmark.
189 patients 18 to 80 years (mean age 63 y, 54% men) with newly diagnosed or highly suspected NSCLC that was considered operable after conventional staging. Exclusion criteria were type 1 diabetes, another malignancy, distant metastases, claustrophobia, or FEV1 < 30% after surgery.
PET-CT scans (n = 98) or conventional staging (n = 91).
Included futile thoracotomies (benign lung lesions, pathologically confirmed stage IIIA disease, stage IIIB or IV disease, inoperable T3 or T4 disease, or disease recurrence or death within 12 mo) and mortality.
61% of patients in the PET-CT group and 80% in the conventional group had operable disease and underwent thoracotomy. Overall, patients in the PET-CT group had fewer futile thoracotomies than those in the conventional group; results were similar in the subgroup of patients who had thoracotomy (Table). Groups did not differ for mortality (Table).
In patients with non–small-cell lung cancer, preoperative staging using positron-emission tomography plus computed tomography reduced futile thoracotomies more than conventional staging.
Positron-emission tomography plus computed tomography (PET-CT) vs conventional preoperative staging (CS) in non–small-cell lung cancer‡
‡Abbreviations defined in Glossary. RRR, RRI, NNT, NNH, and CI calculated from data in article.
§Benign disease, confirmed stage IIIA disease, stage IIIB or IV disease, inoperable T3 or T4 disease, or disease recurrence or death within 12 months.
Blaivas AJ. Preoperative staging using PET-CT reduced futile thoracotomies more than conventional staging in non–small-cell lung cancer. Ann Intern Med. ;151:JC5–8. doi: 10.7326/0003-4819-151-10-200911170-02008
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Published: Ann Intern Med. 2009;151(10):JC5-8.
Hematology/Oncology, Lung Cancer, Pulmonary/Critical Care.
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