Preoperative evaluation of stage I and stage II non-small cell lung cancer.
The appropriate preoperative evaluation for occult metastasis in patients with potentially resectable lung cancer remains controversial. The records of 265 patients with stage I and II non-small cell lung cancers who underwent resection with curative intent were reviewed to determine if there was a survival benefit of negative preoperative scanning to detect metastases. A minimum of 5 years of follow-up was possible for all long-term survivors. Patients having preoperative bone scans, brain imaging, and abdominal imaging had no increased survival over those without such evaluation (using Kaplan-Meier survival curves). Additionally, no difference was found in the time to first recurrence between these groups, and the site of recurrence was independent of a negative preoperative scan for that location. These data, using patient outcome as the basis of our conclusion, support a policy of reserving expensive preoperative metastatic evaluations only for those patients with clinical evidence of metastatic disease.
Hatter
J
J
Department of Surgery, SUNY Health Science Center, Syracuse 13210.
Kohman
L J
LJ
Mosca
R S
RS
Graziano
S L
SL
Veit
L J
LJ
Coleman
M
M
D000008:Abdominal Neoplasms / Q000175:diagnosis / Q000556:secondary; D001859:Bone Neoplasms / Q000175:diagnosis / Q000556:secondary; D001932:Brain Neoplasms / Q000175:diagnosis / Q000556:secondary; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D009367:Neoplasm Staging; D011300:Preoperative Care; D011877:Radionuclide Imaging / Q000706:statistics & numerical data; D015996:Survival Rate; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data; D016896:Treatment Outcome