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F. Kutluhan



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    P1.12 - Poster Session 1 - NSCLC Early Stage (ID 203)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Medical Oncology
    • Presentations: 1
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      P1.12-004 - Accuracy of PET/CT in the Evaluation of N1 and N2 Lymph Node Stations in Operable NSCLC (ID 1181)

      09:30 - 09:30  |  Author(s): F. Kutluhan

      • Abstract

      Background
      Aim: Mediastinal lymph node metastases are frequent in non small cell carcinomas (NSCLC). We aimed to investigate the diagnostic accuracy of PET-CT for different mediastinal lymph nodes in operable NSCLC patients by comparing PET-CT results with cervical mediastinoscopy and thoracotomy findings.

      Methods
      Methods: Medical records of 124 operable NSCLC patients to whom PET-CT was applied for clinical staging between November 2009 and December 2011 were evaluated retrospectively. PET-CT was negative in 64 of 124 patients. Thirty-four of the patients underwent cervical mediastinoscopy, 4 underwent anterior mediastinotomy, 3 underwent thoracotomy and the remaining 83 were operated without any prior invasive procedure. PET/CT uptake of different stations were explored, sensitivity, specifity, negative (NPV) and positive predictive (PPV) values and accuracy rates were calculated

      Results
      Results: Sensitivity, specifity, PPV, NPV and accuracy rates for N1 and N2 lymph nodes are shown in the table. Accuracy rates were low for 4th, 7th and 10th numbered lymph nodes. However any significant correlation was not observed between pathology and PET-CT for nodal stations 3 and 10.

      % Sensitivity Specifity PPV NPV Accuracy
      N1 8 94 21 82 78
      N2 57 93 49 95 89

      Conclusion
      Conclusion: The lower rates of PET-CT sensitivity and PPV for N1 lymph nodes than N2 lymph nodes reflect the poor success rates of N1 determination with PET-CT. The lower accuracy rates of 4, 7 and 10 station lymph nodes with PET-CT as well as the pathology and PET-CT uncorrelation for 3 and 10 lymph nodes might be explained by the close localization of these stations to N1 lymph nodes and the restriction of the PET-CT in discrimination of N2 lymph nodes from N1 in this area.

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    P2.12 - Poster Session 2 - NSCLC Early Stage (ID 205)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Medical Oncology
    • Presentations: 2
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      P2.12-007 - PET/CT Findings of Adenocarcinoma Patients (ID 1175)

      09:30 - 09:30  |  Author(s): F. Kutluhan

      • Abstract

      Background
      AIM: New classification of adenocarcinoma subtypes cannot be discriminated by PET/CT findings. The aim of this study was to evaluate the features of operable adenocarcinoma patients according to PET/CT findings.

      Methods
      METHODS: Medical records of 49 adenocarcinoma patients to whom PET-CT was applied for clinical staging between November 2009 and December 2011 were evaluated retrospectively.

      Results
      RESULTS: Mean tumor size was 3,51±1,70 and mean tumor SUV max value was 8,18±4,50. Tumor size and tumor SUV max values were not different between subtypes. Seventeen of the patients had positive and 8 had suspicious positive mediastinal lymph nodes, however only 16 of the positive N2 lymph nodes were determined to be pathologically positive by mediastinoscopy or thoracotomy. Tumor SUV max values were found to be correlated with tumor size (r=0,493, p<0,001). The most frequent subtype was unclassified (32 patients). The others were mixed (6), acinar (4), lepidic (3), mucinous (2), solid (1) and papillary (1) subtypes.

      Conclusion
      CONCLUSION: We need studies involving more patients to evaluate the differences between PET/CT uptakes of adenocarcinoma subtypes, although we observed an association with tumor size and SUV max values of the adenocarcinomas regardless from the histopathological subtypes.

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      P2.12-008 - Do PET/CT Findings Predict Clinical Staging in NSCLC ? (ID 1183)

      09:30 - 09:30  |  Author(s): F. Kutluhan

      • Abstract

      Background
      AIM: Staging of lung cancer determines the choice for treatment. Currently, PET/CT has been used widely in the staging NCSLC. We aimed to investigate the changes in clinical staging of NSCLC patients after PET/CT procedure.

      Methods
      METHODS: Clinical and pathological data of 124 operable NSCLC patients to whom PET-CT was applied for clinical staging between November 2009 and December 2011 were evaluated retrospectively. PET-CT was positive for N2 lymph nodes in 60 of 124 patients. Thirty of them underwent mediastinoscopy, 4 underwent mediastinotomy and 2 underwent thoracotomy and the remaining 24 were operated without any prior invasive procedure for the evaluation of mediastinal lymph nodes. Among the 64 PET/CT negative patients 59 were directly operated, 4 underwent mediastinoscopy and 1 to thoracotomy.

      Results
      RESULTS: Stage 3A was the most frequent stage in both clinical and pathological staging. T staging was the same for both clinical and pathological stages in 48%of the patients, while this was 58% for mediastinal lymph nodes. Overall clinical and pathological stages were the same in 42% of the patients, while in 34% clinical staging was lower and in 24% higher than the pathological staging. The most compliant stage between clinical and pathological stages was 1A while the least one was stage 1B.

      Conclusion
      CONCLUSION: Clinical staging with the assistance of PET/CT was observed to be moderate compliant with pathological staging in most of the patients. Therefore, clinical staging with PET/CT should not replace pathological staging in NSCLC

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    P3.12 - Poster Session 3 - NSCLC Early Stage (ID 206)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Medical Oncology
    • Presentations: 1
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      P3.12-003 - Preoperative Management of NSCLC Patients With PET/CT N2 Positive Mediastinal Lymph Nodes (ID 1179)

      09:30 - 09:30  |  Author(s): F. Kutluhan

      • Abstract

      Background
      AIM: PET/CT has been widely used in the diagnosis and management of lung cancer patients. We aimed to investigate the progress of N2 positive NSCLC patients after PET-CT examinations.

      Methods
      METHODS: Clinical and pathological data of 124 operable NSCLC patients to whom PET-CT was applied for clinical staging between November 2009 and December 2011 were evaluated retrospectively.

      Results
      RESULTS: PET-CT was positive for N2 disease in 60 patients. Among them 24 were operated without any prior invasive procedure, while the remaining was investigated with different procedures for mediastinal lymph node involvement. Thirty of them had cervical mediastinoscopy, 4 had anterior mediastinotomy and 2 had thoracotomy. N2 positivity determined in nodal stations 5 and 7 was also corrected with thoracotomy. However, N2 involvement was not observed in one patient who underwent anterior mediastinotomy and 13 patients who underwent cervical mediastinoscopy, although they had positive PET/CT results. The overall true positivity within these patients who underwent preoperative diagnostic procedures for N2 lymph nodes was 22 out of 36 patients (61%). N2 lymph node involvement was observed in 6 of the 24 patients who were directly operated (25%).

      Conclusion
      CONCLUSION: Although PET/CT had an important contribution in the preoperative management of NSCLC patients, histopathological confirmation remains the golden standard for operable cases.