The effect of FDG-PET on the stage distribution of non-small cell lung cancer.
OBJECTIVE
To study the impact of F-fluorodeoxyglucose positron emission tomography (FDG-PET) on stage distribution and survival for patients with newly diagnosed non-small cell lung cancer (NSCLC).


METHODS
We searched the Barnes-Jewish Hospital/Washington University School of Medicine database for patients with non-small cell lung cancer (NSCLC) diagnosed between January 1, 1990 and December 31, 2004. Since the use of FDG-PET increased in our institution in the year 2000, patients were subdivided into those diagnosed before or after January 1, 2000. We compared the stage distribution of NSCLC before and after the year 2000. We also compared the survival for patients diagnosed between 2000 and 2004 staged with or without FDG-PET.


RESULTS
We identified 6118 patients diagnosed with NSCLC, with 3765 (61%) diagnosed before the year 2000 and 2362 (39%) thereafter. The use of FDG-PET was significantly increased after the year 2000 (37% versus 7%, p < 0.001) and there was a significant increase in the proportion of stage IV patients (30-37%, p < 0.001) with an associated decrease in stages I and III. Median overall survival was increased in all patients with stage IV disease diagnosed after the year 2000 (5.8 months versus 4.5 months). Patients with stage III or IV disease staged with FDG-PET scan also had improved survival compared with those undergoing conventional staging


CONCLUSIONS
The increased use of FDG-PET was associated with a stage migration in patients with NSCLC, which may partially account for improvements in survival as compared with historical controls.
Morgensztern
Daniel
D
Division of Oncology, Department of Medicine, Washington University School of Medicine, USA.
Goodgame
Boone
B
Baggstrom
Maria Q
MQ
Gao
Feng
F
Govindan
Ramaswamy
R
D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging* / Q000401:mortality / Q000473:pathology; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000401:mortality / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods* / Q000639:trends; D049268:Positron-Emission Tomography / Q000706:statistics & numerical data; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D015996:Survival Rate; D014481:United States / Q000453:epidemiology
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18