Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/11065
Title: Long-term survival of 42 patients with resected N2 non-small-cell lung cancer: the impact of 2-(18)F-fluoro-2-deoxy-D-glucose positron emission tomogram mediastinal staging.
Authors: Barnett, Stephen A;Baste, Jean-Marc;Murugappan, Kowsi;Tog, Check;Berlangieri, Salvatore U;Scott, Andrew M;Seevanayagam, Siven;Knight, Simon R
Affiliation: Department of Thoracic Surgery, Austin Health, Heidelberg, Victoria, Australia. stephenarthurbarnett@gmail.com
Issue Date: 1-Jul-2010
Citation: European Journal of Cardio-thoracic Surgery : Official Journal of the European Association For Cardio-thoracic Surgery 2010; 39(1): 96-101
Abstract: Prognostic information known preoperatively allows stratification of patients to surgery; induction therapy and surgery; or definitive chemoradiotherapy and may prevent a futile thoracotomy. Attention has focussed on the standard uptake value (SUV) of the primary tumour but less has been described regarding the 18F-fluoro-2-deoxy-D-glucose (18F-FDG) avidity of mediastinal nodes. We aimed, in a group of surgically resected cN0-1 but pN2 tumours, to compare the survival of patients with and without 18F-FDG avid mediastinal nodes.Retrospective review of a surgical database identified cN0-1 non-small-cell lung cancer (NSCLC) patients with pN2 disease after resection. Survival of non-FDG avid N2 versus FDG avid N2 groups was compared after stratification according to variables found on univariate analysis to affect survival.From January 1993 to December 2006, 42 patients were identified; 27 (64%) had non-FDG avid N2 disease. Five-year and median survival were better in the non-FDG avid N2 disease group, 25% versus 0% and 30 (16-44) versus 13 (10-16) months, respectively (p=0.02). After 1998, the difference in survival was 41% versus 0% and 35 (14-56) versus 12 (16-18) months, respectively (p=0.02).After resection, patients with non-FDG avid N2 disease have better survival than patients with FDG avid N2 disease. Exploratory thoracotomy alone (after frozen section analysis) cannot be advocated in patients with non-FDG avid N2 disease as survival after resection appears at least equivalent to alternate therapeutic approaches in this group. This assertion may be tempered if right pneumonectomy is required or R0 resection is unachievable. Mediastinal nodal avidity may improve stratification in future studies of long-term survival in NSCLC.
Internal ID Number: 20580245
URI: http://ahro.austin.org.au/austinjspui/handle/1/11065
DOI: 10.1016/j.ejcts.2010.04.040
URL: http://www.ncbi.nlm.nih.gov/pubmed/20580245
Type: Journal Article
Subjects: Aged
Carcinoma, Non-Small-Cell Lung.pathology.radionuclide imaging.secondary.surgery
Epidemiologic Methods
Female
Fluorodeoxyglucose F18.diagnostic use
Humans
Lung Neoplasms.pathology.radionuclide imaging.surgery
Lymphatic Metastasis
Male
Mediastinum
Middle Aged
Neoplasm Staging
Pneumonectomy
Positron-Emission Tomography.methods
Postoperative Complications
Prognosis
Radiopharmaceuticals.diagnostic use
Treatment Outcome
Appears in Collections:Journal articles

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