Background. In accordance with the new classification, stages from IA to IIIA are considered surgically resectable with a possible role for neoadjuvant or adjuvant chemotherapy and radiotherapy. In pts at stage IIIB-IV of disease, surgical resection is considered impracticable, and chemotherapy–radiation therapy becomes the primary treatment. The aim of our study was to compare the role of FDG PET/CT vs. diagnostic CT in order to evaluate the impact on surgical management. Materials and methods: We retrospectively reviewed both PET/CT and CT scans of 67 pts(69±9years)with lung cancer. Based on their findings, the sites of primary lung lesions, lymph nodes and metastases were tabulated and the final staging was computed according to the new classification. A comparison across diagnostic and metabolic imaging was performed. Results: Based on CT findings, 19 pts were at stage I; 8 at stage II; 13 at stage IIIA; 7 at stage IIIB and 20 at stage IV. No concordance between imaging modalities was reported in 30pts, particularly based on PET/CT 15 were downstaged and 15 upstaged. Twenty-nine out of 67pts underwent surgery. According to PET/CT, 3 patients underwent surgery by a change in staging from IIIB-IV to I and IIIA. On the contrary, no surgical management was adopted in 6pts due to upstaging(from I-IIIA to IV). Therefore, PET/CT changed the surgical management in 9/67pts. Conclusion: According to the new TNM classification, PET/CT contributes to determine the surgical treatment in about 15%of lung cancer pts, thus improving preoperative staging and reducing the number of needless surgery.

The role of fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) versus diagnostic CT in surgical management of patients (pts) with lung cancer according to the 7th TNM classification

MUZZIO, PIER CARLO;POMERRI, FABIO
2013

Abstract

Background. In accordance with the new classification, stages from IA to IIIA are considered surgically resectable with a possible role for neoadjuvant or adjuvant chemotherapy and radiotherapy. In pts at stage IIIB-IV of disease, surgical resection is considered impracticable, and chemotherapy–radiation therapy becomes the primary treatment. The aim of our study was to compare the role of FDG PET/CT vs. diagnostic CT in order to evaluate the impact on surgical management. Materials and methods: We retrospectively reviewed both PET/CT and CT scans of 67 pts(69±9years)with lung cancer. Based on their findings, the sites of primary lung lesions, lymph nodes and metastases were tabulated and the final staging was computed according to the new classification. A comparison across diagnostic and metabolic imaging was performed. Results: Based on CT findings, 19 pts were at stage I; 8 at stage II; 13 at stage IIIA; 7 at stage IIIB and 20 at stage IV. No concordance between imaging modalities was reported in 30pts, particularly based on PET/CT 15 were downstaged and 15 upstaged. Twenty-nine out of 67pts underwent surgery. According to PET/CT, 3 patients underwent surgery by a change in staging from IIIB-IV to I and IIIA. On the contrary, no surgical management was adopted in 6pts due to upstaging(from I-IIIA to IV). Therefore, PET/CT changed the surgical management in 9/67pts. Conclusion: According to the new TNM classification, PET/CT contributes to determine the surgical treatment in about 15%of lung cancer pts, thus improving preoperative staging and reducing the number of needless surgery.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11577/2686275
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