High impact of 18F-FDG-PET on management and prognostic stratification of newly diagnosed small cell lung cancer.
OBJECTIVE
We evaluated whether 18F-FDG-PET altered stage classification, management, and prognostic stratification of newly diagnosed small cell lung cancer (SCLC).


METHODS
We identified 46 consecutive patients undergoing staging positron emission tomography for SCLC from 1993-2008 inclusive. Updated survival data from the state Cancer Registry was available on 42 of 46 patients.


RESULTS
PET altered stage classification in 12 of 46 (26%) patients. PET altered treatment modality in nine patients, and the target mediastinal radiation field in another three patients. Therefore, PET altered management in 12 of 46 (26%) patients. Patients with limited disease (LD) on pre-PET staging had significantly longer overall survival (OS) than those upstaged to extensive disease (ED; median 18.6 months versus 5.7 months; log-rank p < 0.0001). In patients with ED on pre-PET staging, those downstaged to LD by PET had significantly longer OS than those with ED on PET (median 10.9 months versus 5.9 months; log-rank p = 0.037).


CONCLUSIONS
PET had a major impact on stage classification, management, and prognostic stratification of newly diagnosed SCLC.
Azad
Arun
A
Ludwig Institute Oncology Unit, Austin Health, Heidelberg, Australia. arun.azad1978@gmail.com
Chionh
Fiona
F
Scott
Andrew M
AM
Lee
Szeting T
ST
Berlangieri
Sam U
SU
White
Shane
S
Mitchell
Paul L
PL
D000368:Aged; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy*; D008297:Male; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D011379:Prognosis; D016016:Proportional Hazards Models; D055752:Small Cell Lung Carcinoma / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy*; D014057:Tomography, X-Ray Computed
D019788:Fluorodeoxyglucose F18