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C. Endo
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P1.06 - Poster Session/ Screening and Early Detection (ID 218)
- Event: WCLC 2015
- Type: Poster
- Track: Screening and Early Detection
- Presentations: 1
- Moderators:
- Coordinates: 9/07/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P1.06-027 - Role of Brain MRI and PET-CT in Follow-Up after Lung Cancer Surgery (ID 1674)
09:30 - 09:30 | Author(s): C. Endo
- Abstract
Background:
Standard follow-up method after pulmonary resection for lung cancer is not determined. While chest computed tomography (CT) is widely utilized, brain magnetic resonance imaging (MRI) and positron emission tomography (PET) are also used as follow-up examination to detect cancer recurrence recently. Object of this study is to clarify the ability of MRI and PET to detect recurrence as follow-up examination setting.
Methods:
Medical records of 281 patients with lung cancer who underwent complete pulmonary resection for lung cancer from 2009 to 2012 were retrospectively reviewed. Information regarding recurrence, such as site of recurrence, time after surgery, tumor markers, and survival, were collected. Pathological stage according to 7[th] version of TNM staging was IA/IB/IIA/IIB/IIIA for 143/75/23/16/24 patients, respectively. Number of the patients with adenocarcinoma/squamous cell carcinoma/large cell carcinoma/small cell carcinoma/pleomorphic carcinoma/others was 190/71/2/2/7/9, respectively. All PET images were combined with simultaneously performed CT scan. Statistical analysis was performed using Mann-Whitney test for comparing groups and log-rank test for survival analysis. P-values less than 0.05 were regarded as significance.
Results:
CT was utilized for 255(90.7%), brain MRI for 130 (46.3%), and PET for 102 (36.3%). Recurrence of lung cancer was observed in 58 patients (20.6%). 　Pathological stage was IA/IB/IIA/IIB/IIIA for 11/14/12/7/14 patients, respectively. Initial recurrent site was intrathorax/bone/brain/adrenal gland/liver for 34/15/5/3/1 patients, respectively. Motive to detect initial recurrence was patients’ symptom/CT/MRI/PET for 16/24/3/15 patients, respectively. Brain MRI detected 3 out of 5 (60%) of brain metastasis as an initial recurrence in asymptomatic status. PET detected 8 out of 15(53.3%) of bone metastasis as an initial recurrence in asymptomatic status. In 19 of 48 (39.6%) patients, elevation of tumor markers beyond normal range was observed before detection of metastasis by diagnostic imaging examination. Time after surgery to initial recurrence was shorter in symptom-detected group than in examination-detected group (median 233 versus 404 days, p<0.001). Similarly, survival after initial recurrence was shorter in symptom-detected group than in examination-detected group (median 149 versus 916 days, p<0.001).
Conclusion:
Follow up after lung cancer surgery utilizing brain MRI and PET effectively detect ansymptomatic metastasis to brain and bone. Survival benefit need be concluded by different setting. Furthermore, economic efficiency are also warranted to be analyzed.
