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T. Smit
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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)
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P3.13-021 - Can Lymph Nodes Visualised on PET/CT Predict the Outcome of Patients with Lung Cancer? (ID 9788)
09:30 - 09:30 | Author(s): T. Smit
- Abstract
Background:
Non-small cell lung cancer (NSCLC) is the common type of histology among all cases of lung cancer. Studies have shown that PET/CT is more accurate than CT for the detection of nodal status due to the increased FDG uptake in very small nodes. In fact, tumor-node-metastasis staging of the mediastinum is currently one the most common indications of PET/CT in lung cancer. The aim of this pilot retrospective review was to assess the role PET/CT as a non-invasive procedure for the visualised lymph nodes in lung cancer.
Method:
Twenty-nine patients [NSCLC (86%), NET (10%), SCL (4%)] underwent PET/CT imaging and were followed for a period of at least 3 years. There were 15 females (51.72%) and 14 males (48.28%) aged between 38-78 years (mean +/- SD= 61.24+/- 9.86) and were referred for staging (86%), restaging (10%) and response to therapy (4%). All patients underwent 18F-FDG PET/CT with a mean time of 71.2 minutes after tracer injection. Tumor and lymph node uptake were evaluated with both visual and quantitative assessment.
Result:
Seven patients (24%) died at 12 months despite treatment induction and by the end of two years follow-up, just a little more than half (51.72%) of the patients died. The majority of those who died were males (r=-0.38; p=0.041). Active lymph nodes were seen in one nodal station in 19 patients. They were also seen in two nodal stations in 12 patients and in three nodal stations in 5 patients. The common stations were as follows: Hilar (33.3%), right lower Para tracheal (22.2%) and subcarinal (19.4%). While no significant association was seen between the primary location of tumor and the occurrence of lymph nodes, patients with positive nodes on PET/CT staging tend to have a reduced survival than those without visualized lymph nodes [odd ratio= 2.33, 95% CI 1.60-9.02; p=0.08]. However, when the analysis was only done for the NSCLC group, a significant reduction of survival was noted in patients who had positive lymph nodes (p<0.01).
Conclusion:
This small cohort confirmed the predominance of NSCLC as described in the literature. While this histological predominance could result from a referral bias, it clearly showed that the male gender was associated with a reduced survival. However, a larger cohort must be studied in a prospective analysis to confirm the significantly reduced survival among NSCLC patients with positive lymph nodes during staging, for PET/CT imaging to become a robust predictor of survival.
