Author of

• 20192

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  P3.13 - Radiology/Staging/Screening (ID 729)

  • Event: WCLC 2017
  • Type: Poster Session with Presenters Present
  • Track: Radiology/Staging/Screening
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/18/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)

  • 24159

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    P3.13-007 - A Feasible Follow-Up Program Using FDG-PET/CT for Asymptomatic Postoperative Non-Small-Cell Lung Cancer Patients (ID 8194)

    09:30 - 09:30  |  Author(s): N. Kawakita
    • Abstract

    Background:
    There is no consensus on the best program for postoperative follow-up and surveillance after curative resection for non-small cell lung cancer (NSCLC) patients at this time. We reported that the diagnostic capability of [18]F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) was high in postoperative NSCLC patients without clinical and radiological evidence of recurrence (ICVTS 2012). However, there were some problems, such as radiation exposure and its cost. The aim of this study was to propose a more feasible follow-up and surveillance program using FDG-PET/CT for asymptomatic postoperative NSCLC patients.
    
    Method:
    Between January 2005 and December 2013, a total of 172 NSCLC patients (98 males and 74 females; mean age: 67.8 years) underwent potentially curative operations, and follow-up FDG-PET/CT was performed in patients without clinical or radiological evidence of recurrence for at least once a year in principle. A total of 481 FDG-PET/CT studies were entered and retrospectively reviewed.
    
    Result:
    The histological type was adenocarcinoma in 129 patients, squamous cell carcinoma in 36 and others in 7. The pathological stage was Stage 0 in 2 patients, IA in 106, IB in 28, IIA in 15, IIB in 7, and IIIA in 14 (UICC 7[th]. edition). Surgical procedures were pneumonectomy in 5 patients, lobectomy in 139, segmentectomy in 14, and partial resection with a sufficient margin in 14. The mean time interval between the initial surgery and latest follow-up was 49.1 months. During the follow-up period, the mean number of times that FDG-PET/CT was performed per patient was 2.8. FDG-PET/CT correctly diagnosed recurrence in 31 of 32 (96.9%) patients and 41 of 42 (97.1%) recurrent sites. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were 96.9, 97.1, 88.6, 99.3, and 97.1%, respectively. In 6 (3.5%) patients, other diseases were detected and treated appropriately. On the other hand, FDG-PET/CT performed within 3 years after the operation detected significantly more FDG-positive lesions compared to after 4 years (10.0 vs. 2.0%, respectively, p=0.007). Additionally, in 147 patients with recurrence after curative operations between 2005 and 2013 in our institute, recurrence occurred in 123 patients (83.7%) within 3 years.
    
    Conclusion:
    FDG-PET/CT has a high capability to detect recurrence in asymptomatic NSCLC patients after a potentially curative operation. However, it might be sufficient to perform FDG-PET/CT up until 3 years after the operation. A large scale multi-institutional randomized control trial is warranted to ascertain the benefit of surveillance with FDG-PET/CT.