Using pet-ct to Reduce Futile Thoracotomy Rates in Non-Small-Cell Lung Cancer: A Population-Based Review

Smoragiewicz, Martin; Laskin, Janessa; Wilson, Don; Ramsden, K.; Yee, John; Lam, Stephen; Shaipanich, Tawimas; Zhai, Yongliang; Ho, Cheryl

doi:10.3747/co.21.2125

Cited by 9 publications

(6 citation statements)

References 28 publications

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“…However, both of these methods can be impacted by relatively subtle changes in scope pressure and method of image acquisition. Of the 75 patients recruited, 9 (12%) had N2 disease found at surgery which is lower than other published data . A 12% futile thoracotomy rate as highlighted by the authors is not perfect, but would overall be deemed acceptable as it reflects the fact that the role of the MDT is to give patients the benefit of the doubt for surgery where doubt exists.…”

mentioning

confidence: 71%

“…Of the 75 patients recruited, 9 (12%) had N2 disease found at surgery which is lower than other published data. 13 A 12% futile thoracotomy rate as highlighted by the authors is not perfect, but would overall be deemed acceptable as it reflects the fact that the role of the MDT is to give patients the benefit of the doubt for surgery where doubt exists. This reflects best practice guidelines.…”

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confidence: 97%

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Refining the role of endobronchial ultrasound transbronchial needle aspiration in lung cancer staging

Nguyen

2017

Respirology

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confidence: 71%

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confidence: 97%

Refining the role of endobronchial ultrasound transbronchial needle aspiration in lung cancer staging

Nguyen

2017

Respirology

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“…Although PET-CT has reduced the number of futile thoracotomies, its sensitivity and specificity range from 75% to 95% for detecting metastatic disease. 22 Various studies have shown the stage of the disease correlates with survival, but in cases of equivocal disease due to either small lesions or a tumor with low metabolism, for example, bronchoalveolar carcinoma, 23 abnormal blood markers such as elevated plasma fibrinogen may serve as an adjunct to indicate a more advanced stage. Similarly, in patients with borderline fitness for curative resection, abnormal blood markers may be a useful marker of poor outcome and help in making the decision to proceed with either surgery or radical radio/chemotherapy.…”

Section: Discussionmentioning

confidence: 99%

Role of preoperative blood markers as prognostic factors for lung cancer surgery

Hamid

Al-Saudi

Paul

et al. 2019

Asian Cardiovasc Thorac Ann

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Objective This study was undertaken to assess the potential value of preoperative blood components as prognostic markers of outcome after lung cancer resection, and hence their potential to aid in the selection of patients for curative surgery. Methods This was a single-center study on 313 patients who underwent surgery for non-small-cell lung cancer from 2006 to 2008. Data were analyzed retrospectively from a prospectively maintained thoracic database. Preoperative blood results including plasma fibrinogen levels, serum C-reactive protein, hemoglobin concentration, and platelet count were included in the analysis. Results The mean age was 75 years, and 40% of the patients were females. The most common resection was lobectomy in 68% of patients, followed by pneumonectomy, wedge resection, and segmentectomy in 18%, 10%, and 1.6%, respectively. Patients with abnormal C-reactive protein, fibrinogen, and hemoglobin levels had a worse overall survival. Large tumor size and nodal metastasis on clinical staging was also associated with poor survival. However, on Cox regression analysis, plasma fibrinogen and nodal metastasis were the only independent predictors of survival after lung resection. Conclusions Among the different blood markers, elevated preoperative plasma fibrinogen was an independent marker of reduced survival in patients with resected non-small-cell lung cancer, and its value in selecting patients who may benefit from surgery needs further investigation.

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“…Imaging plays an essential role in the clinical or cTNM classification, with CT being the method of choice, given its wide availability [ 12 ]. In addition, 18 F-FDG PET/CT has become another standard tool in pre-treatment assessment, with advantages over conventional techniques, for staging both the mediastinum [ 13 , 14 ], as well as extrathoracic disease [ 15 ] having demonstrated it lowers the number of useless thoracotomies, and improves cost-effectiveness in the management of these patients [ 16 ]. Therefore, given the importance of an integrated morphological-functional assessment for proper treatment planning, one technique without the other is not understandable.…”

Section: To Define the Applications Of Functional And Molecular Imagimentioning

confidence: 99%

SEOM–SERAM–SEMNIM guidelines on the use of functional and molecular imaging techniques in advanced non-small-cell lung cancer

et al. 2017

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Imaging in oncology is an essential tool for patient management but its potential is being profoundly underutilized. Each of the techniques used in the diagnostic process also conveys functional information that can be relevant in treatment decision-making. New imaging algorithms and techniques enhance our knowledge about the phenotype of the tumor and its potential response to different therapies. Functional imaging can be defined as the one that provides information beyond the purely morphological data, and include all the techniques that make it possible to measure specific physiological functions of the tumor, whereas molecular imaging would include techniques that allow us to measure metabolic changes. Functional and molecular techniques included in this document are based on multi-detector computed tomography (CT), 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET), magnetic resonance imaging (MRI), and hybrid equipments, integrating PET with CT (PET/CT) or MRI (PET-MRI). Lung cancer is one of the most frequent and deadly tumors although survival is increasing thanks to advances in diagnostic methods and new treatments. This increased survival poises challenges in terms of proper follow-up and definitions of response and progression, as exemplified by immune therapy-related pseudoprogression. In this consensus document, the use of functional and molecular imaging techniques will be addressed to exploit their current potential and explore future applications in the diagnosis, evaluation of response and detection of recurrence of advanced NSCLC.

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Using pet-ct to Reduce Futile Thoracotomy Rates in Non-Small-Cell Lung Cancer: A Population-Based Review

Cited by 9 publications

References 28 publications

Refining the role of endobronchial ultrasound transbronchial needle aspiration in lung cancer staging

Refining the role of endobronchial ultrasound transbronchial needle aspiration in lung cancer staging

Role of preoperative blood markers as prognostic factors for lung cancer surgery

SEOM–SERAM–SEMNIM guidelines on the use of functional and molecular imaging techniques in advanced non-small-cell lung cancer

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