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FDG PET/CT and mediastinal nodal metastasis detection in stage T1 non-small cell lung cancer: prognostic implications.

Shin KM, Lee KS, Shim YM, Kim J, Kim BT, Kwon OJ, Park K - Korean J Radiol (2008 Nov-Dec)

Bottom Line: After estimating the efficacy of PET/CT for detecting N2 disease, we determined and compared disease-free survival (DFS) rates in three groups (P-TN [n = 161], PET/CT FN [n = 12], and PET/CT true positive [TP, n = 11]) using the Kaplan-Meier analysis and log-rank test.The 3-year DFS rate in the PET/CT FN group (31%, 95% confidence interval [CI]; 13.6-48.0%) was similar to that of the TP group (16%, 95% CI; 1.7-29.5%) (p = 0.649), but both groups had significantly shorter DFS rates than the P-TN group (77%, 95% CI; 72.0-81.2%) (p < 0.001).Patients with PET/CT FN N2 disease have survival rates similar to PET/CT TP N2 disease patients, which are both substantially shorter than the survival rate of P-TN patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. kyungs.lee@samsung.com

ABSTRACT

Objective: We aimed to compare the prognoses of patients with pathologically true negative (P-TN) N2 and PET/CT false negative (FN) results in stage T1 non-small cell lung cancer (NSCLC).

Materials and methods: Our institutional review board approved this retrospective study with a waiver of informed consent. The study included 184 patients (124 men and 60 women; mean age, 59 years) with stage T1 NSCLC who underwent an integrated PET/CT and surgery. After estimating the efficacy of PET/CT for detecting N2 disease, we determined and compared disease-free survival (DFS) rates in three groups (P-TN [n = 161], PET/CT FN [n = 12], and PET/CT true positive [TP, n = 11]) using the Kaplan-Meier analysis and log-rank test.

Results: Pathologic N2 disease was observed in 23 (12%) patients. PET/CT had an N2 disease detection sensitivity of 48% (11 of 23 patients), a specificity of 95% (153 of 161), and an accuracy of 89% (164 of 184). The 3-year DFS rate in the PET/CT FN group (31%, 95% confidence interval [CI]; 13.6-48.0%) was similar to that of the TP group (16%, 95% CI; 1.7-29.5%) (p = 0.649), but both groups had significantly shorter DFS rates than the P-TN group (77%, 95% CI; 72.0-81.2%) (p < 0.001).

Conclusion: The PET/CT shows a high specificity, but low sensitivity for detecting N2 disease in stage T1 NSCLC. Patients with PET/CT FN N2 disease have survival rates similar to PET/CT TP N2 disease patients, which are both substantially shorter than the survival rate of P-TN patients.

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Related in: MedlinePlus

Diagram illustrating comparison of overall survival of 184 patients belonging to pathologic true negative (TN), PET/CT false negative (FN), and true positive (TP) groups. Survival is significantly better in true negative group than false negative or true positive group.
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Figure 4: Diagram illustrating comparison of overall survival of 184 patients belonging to pathologic true negative (TN), PET/CT false negative (FN), and true positive (TP) groups. Survival is significantly better in true negative group than false negative or true positive group.

Mentions: The three-year OS rate in the PET/CT FN group (43%, 95% confidence interval [CI]; 25.0 to 60.0%) was similar to that of the TP group (49%, 95% CI; 29.9 to 67.5%) (p = 0.863), however both groups had significantly lower OS rates than the P-TN group (90%, 95% CI; 86.5 to 93.1) (p < 0.001) (Fig. 4). Moreover, the three-year DFS rate in the PET/CT FN group (31%, 95% CI; 13.6 to 48.0%) was not statistically different from that of the TP group (16%, 95% CI; 1.7 to 29.5%) (p = 0.649); however, both groups had significantly lower DFS rates than the P-TN group (77%, 95% CI; 72.0 to 81.2%) (p < 0.001) (Fig. 5).


FDG PET/CT and mediastinal nodal metastasis detection in stage T1 non-small cell lung cancer: prognostic implications.

Shin KM, Lee KS, Shim YM, Kim J, Kim BT, Kwon OJ, Park K - Korean J Radiol (2008 Nov-Dec)

Diagram illustrating comparison of overall survival of 184 patients belonging to pathologic true negative (TN), PET/CT false negative (FN), and true positive (TP) groups. Survival is significantly better in true negative group than false negative or true positive group.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2627243&req=5

Figure 4: Diagram illustrating comparison of overall survival of 184 patients belonging to pathologic true negative (TN), PET/CT false negative (FN), and true positive (TP) groups. Survival is significantly better in true negative group than false negative or true positive group.
Mentions: The three-year OS rate in the PET/CT FN group (43%, 95% confidence interval [CI]; 25.0 to 60.0%) was similar to that of the TP group (49%, 95% CI; 29.9 to 67.5%) (p = 0.863), however both groups had significantly lower OS rates than the P-TN group (90%, 95% CI; 86.5 to 93.1) (p < 0.001) (Fig. 4). Moreover, the three-year DFS rate in the PET/CT FN group (31%, 95% CI; 13.6 to 48.0%) was not statistically different from that of the TP group (16%, 95% CI; 1.7 to 29.5%) (p = 0.649); however, both groups had significantly lower DFS rates than the P-TN group (77%, 95% CI; 72.0 to 81.2%) (p < 0.001) (Fig. 5).

Bottom Line: After estimating the efficacy of PET/CT for detecting N2 disease, we determined and compared disease-free survival (DFS) rates in three groups (P-TN [n = 161], PET/CT FN [n = 12], and PET/CT true positive [TP, n = 11]) using the Kaplan-Meier analysis and log-rank test.The 3-year DFS rate in the PET/CT FN group (31%, 95% confidence interval [CI]; 13.6-48.0%) was similar to that of the TP group (16%, 95% CI; 1.7-29.5%) (p = 0.649), but both groups had significantly shorter DFS rates than the P-TN group (77%, 95% CI; 72.0-81.2%) (p < 0.001).Patients with PET/CT FN N2 disease have survival rates similar to PET/CT TP N2 disease patients, which are both substantially shorter than the survival rate of P-TN patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. kyungs.lee@samsung.com

ABSTRACT

Objective: We aimed to compare the prognoses of patients with pathologically true negative (P-TN) N2 and PET/CT false negative (FN) results in stage T1 non-small cell lung cancer (NSCLC).

Materials and methods: Our institutional review board approved this retrospective study with a waiver of informed consent. The study included 184 patients (124 men and 60 women; mean age, 59 years) with stage T1 NSCLC who underwent an integrated PET/CT and surgery. After estimating the efficacy of PET/CT for detecting N2 disease, we determined and compared disease-free survival (DFS) rates in three groups (P-TN [n = 161], PET/CT FN [n = 12], and PET/CT true positive [TP, n = 11]) using the Kaplan-Meier analysis and log-rank test.

Results: Pathologic N2 disease was observed in 23 (12%) patients. PET/CT had an N2 disease detection sensitivity of 48% (11 of 23 patients), a specificity of 95% (153 of 161), and an accuracy of 89% (164 of 184). The 3-year DFS rate in the PET/CT FN group (31%, 95% confidence interval [CI]; 13.6-48.0%) was similar to that of the TP group (16%, 95% CI; 1.7-29.5%) (p = 0.649), but both groups had significantly shorter DFS rates than the P-TN group (77%, 95% CI; 72.0-81.2%) (p < 0.001).

Conclusion: The PET/CT shows a high specificity, but low sensitivity for detecting N2 disease in stage T1 NSCLC. Patients with PET/CT FN N2 disease have survival rates similar to PET/CT TP N2 disease patients, which are both substantially shorter than the survival rate of P-TN patients.

Show MeSH
Related in: MedlinePlus