Preoperative staging of lung cancer with combined PET-CT
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Preoperative staging of lung cancer with combined PET-CT. / Fischer, Barbara; Lassen, Ulrik; Mortensen, Jann; Larsen, Søren; Loft, Annika; Bertelsen, Anne; Ravn, Jesper; Clementsen, Paul; Høgholm, Asbjørn; Larsen, Klaus; Rasmussen, Torben; Keiding, Susanne; Dirksen, Asger; Gerke, Oke; Skov, Birgit; Steffensen, Ida; Hansen, Hanne; Vilmann, Peter; Jacobsen, Grete; Backer, Vibeke; Maltbaek, Niels; Pedersen, Jesper; Madsen, Henrik; Nielsen, Henrik; Højgaard, Liselotte.
In: New England Journal of Medicine, Vol. 361, No. 1, 2009, p. 32-9.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Preoperative staging of lung cancer with combined PET-CT
AU - Fischer, Barbara
AU - Lassen, Ulrik
AU - Mortensen, Jann
AU - Larsen, Søren
AU - Loft, Annika
AU - Bertelsen, Anne
AU - Ravn, Jesper
AU - Clementsen, Paul
AU - Høgholm, Asbjørn
AU - Larsen, Klaus
AU - Rasmussen, Torben
AU - Keiding, Susanne
AU - Dirksen, Asger
AU - Gerke, Oke
AU - Skov, Birgit
AU - Steffensen, Ida
AU - Hansen, Hanne
AU - Vilmann, Peter
AU - Jacobsen, Grete
AU - Backer, Vibeke
AU - Maltbaek, Niels
AU - Pedersen, Jesper
AU - Madsen, Henrik
AU - Nielsen, Henrik
AU - Højgaard, Liselotte
N1 - Keywords: Adult; Aged; Aged, 80 and over; Carcinoma, Non-Small-Cell Lung; Female; Follow-Up Studies; Humans; Lung Neoplasms; Lymphatic Metastasis; Male; Middle Aged; Neoplasm Staging; Positron-Emission Tomography; Preoperative Care; Sensitivity and Specificity; Thoracotomy; Tomography, X-Ray Computed
PY - 2009
Y1 - 2009
N2 - BACKGROUND: Fast and accurate staging is essential for choosing treatment for non-small-cell lung cancer (NSCLC). The purpose of this randomized study was to evaluate the clinical effect of combined positron-emission tomography and computed tomography (PET-CT) on preoperative staging of NSCLC. METHODS: We randomly assigned patients who were referred for preoperative staging of NSCLC to either conventional staging plus PET-CT or conventional staging alone. Patients were followed until death or for at least 12 months. The primary end point was the number of futile thoracotomies, defined as any one of the following: a thoracotomy with the finding of pathologically confirmed mediastinal lymph-node involvement (stage IIIA [N2]), stage IIIB or stage IV disease, or a benign lung lesion; an exploratory thoracotomy; or a thoracotomy in a patient who had recurrent disease or death from any cause within 1 year after randomization. RESULTS: From January 2002 through February 2007, we randomly assigned 98 patients to the PET-CT group and 91 to the conventional-staging group. Mediastinoscopy was performed in 94% of the patients. After PET-CT, 38 patients were classified as having inoperable NSCLC, and after conventional staging, 18 patients were classified thus. Sixty patients in the PET-CT group and 73 in the conventional-staging group underwent thoracotomy (P=0.004). Among these thoracotomies, 21 in the PET-CT group and 38 in the conventional-staging group were futile (P=0.05). The number of justified thoracotomies and survival were similar in the two groups. CONCLUSIONS: The use of PET-CT for preoperative staging of NSCLC reduced both the total number of thoracotomies and the number of futile thoracotomies but did not affect overall mortality. (ClinicalTrials.gov number, NCT00867412.)
AB - BACKGROUND: Fast and accurate staging is essential for choosing treatment for non-small-cell lung cancer (NSCLC). The purpose of this randomized study was to evaluate the clinical effect of combined positron-emission tomography and computed tomography (PET-CT) on preoperative staging of NSCLC. METHODS: We randomly assigned patients who were referred for preoperative staging of NSCLC to either conventional staging plus PET-CT or conventional staging alone. Patients were followed until death or for at least 12 months. The primary end point was the number of futile thoracotomies, defined as any one of the following: a thoracotomy with the finding of pathologically confirmed mediastinal lymph-node involvement (stage IIIA [N2]), stage IIIB or stage IV disease, or a benign lung lesion; an exploratory thoracotomy; or a thoracotomy in a patient who had recurrent disease or death from any cause within 1 year after randomization. RESULTS: From January 2002 through February 2007, we randomly assigned 98 patients to the PET-CT group and 91 to the conventional-staging group. Mediastinoscopy was performed in 94% of the patients. After PET-CT, 38 patients were classified as having inoperable NSCLC, and after conventional staging, 18 patients were classified thus. Sixty patients in the PET-CT group and 73 in the conventional-staging group underwent thoracotomy (P=0.004). Among these thoracotomies, 21 in the PET-CT group and 38 in the conventional-staging group were futile (P=0.05). The number of justified thoracotomies and survival were similar in the two groups. CONCLUSIONS: The use of PET-CT for preoperative staging of NSCLC reduced both the total number of thoracotomies and the number of futile thoracotomies but did not affect overall mortality. (ClinicalTrials.gov number, NCT00867412.)
U2 - 10.1056/NEJMoa0900043
DO - 10.1056/NEJMoa0900043
M3 - Journal article
C2 - 19571281
VL - 361
SP - 32
EP - 39
JO - New England Journal of Medicine
JF - New England Journal of Medicine
SN - 0028-4793
IS - 1
ER -
ID: 20246396