1623P - Staging and assessment of the response to PET-CT treatment in non-small cell lung carcinoma

Date 09 September 2017
Event ESMO 2017 Congress
Session Poster display session
Topics Non-Small-Cell Lung Cancer, Locally Advanced
Imaging, Diagnosis and Staging
Lung and other Thoracic Tumours
Presenter Miriam Mendez Garcia
Citation Annals of Oncology (2017) 28 (suppl_5): v568-v572. 10.1093/annonc/mdx389
Authors M. Mendez Garcia1, M.A. Brenes2, R. Gómez2, M. Soriano2, M. Torrente1, C. Maximiano2, G. Díaz3, B. Rodríguez4, M.D.M. Córdoba5, M. Provencio Pulla6
  • 1Medical Oncology, Hospital University Puerta de Hierro, 28222 - Majadahonda/ES
  • 2Oncologia Medica, Hospital Universitario Puerta de Hierro, 28222 - Madrid/ES
  • 3Neumologia, Hospital Universitario Puerta de Hierro, 28222 - Madrid/ES
  • 4Medicina Nuclear, Hospital Universitario Puerta de Hierro, 28222 - Madrid/ES
  • 5Thoracic Surgery, Hospital Universitario Puerta de Hierro, 28222 - Madrid/ES
  • 6Servicio De Oncología Médica, Hospital Universitario Puerta de Hierro Majadahond, 28222 - Majadahonda/ES

Abstract

Background

Non-small cell lung cancer (NSCLC) is the leading cause of death from tumors in Western countries. Mediastinal involvement is the most important factor to determine treatment and prognosis. The aim of this study was to analyze the concordance between histological mediastinal staging with that demonstrated by positron emission tomography and computed tomography (PET-CT), in addition to defining the characteristics of this population.

Methods

We prospectively evaluated 244 patients diagnosed with NSCLC at Puerta de Hierro Hospital, from 2009 to 2016. Mediastinal staging was determined by imaging (CT and PET- CT) and anatomo-pathological examination (endobronchial ultrasound, mediastinoscopy or lymphadenectomy). Variables collected included tumor size by CT and PET- CT, lymph node involvement, treatment, and survival. The findings of PET-CT were compared with the histological findings to determine the sensitivity, specificity, and positive (PPV) and negative (NPV) predictive values.

Results

Median of age was 66 years, 74% patients were male,22% were non-smokers. Most common histologies were adenocarcinoma (45%) and squamous (37%). 12% patients presented EGFR mutations (64% 19del) and 3%were ALK-translocated. Staging results by PET-CT were: I (26%), II (21%), III (A 26% and B 14%) and IV (10%).

The correlation in staging between CT and PET-CT, obtaining a kappa index of 0.9 (p 

Conclusions

According to the data observed in our series, there is a strong concordance between the two radiological tests for staging of NSCLC (PET-CT and CT). There is also agreement between PET-CT and subsequent pathological findings in NSCLC in initial stages (I and II). Because of the high sensitivity and NPV of the PET-CT for mediastinal staging, a positive result of this test requires an histological correlation.The increase in the use of PET- CT contributes to more accurate selection of patients for appropriate treatment.

Clinical trial identification

Legal entity responsible for the study

Puerta de Hierro University Hospital

Funding

None

Disclosure

All authors have declared no conflicts of interest.