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Lung Cancer - Staging

Stereotactic ablative radiotherapy versus lobectomy for operable stage I non-small-cell lung cancer: a pooled analysis of two randomised trials
May 20, 2015
A pooled analysis of outcomes from two randomized trials involving SBRT or surgery for operable patients with clinical early stage NSCLC was performed. The number of patients was small (58 total) and the follow-up was a median of 35-40 mos.  Overall 3-year survival was better in the SBRT group (95% vs 79%; p=0.037) whereas recurrence free survival di
Endobronchial Ultrasound versus Mediastinoscopy for Mediastinal Nodal Staging of Non–Small-Cell Lung Cancer
January 29, 2015
There is growing recognition of the utility of EBUS in staging NSCLC.  In this study EBUS and mediastinoscopy were performed in 127 patients requiring mediastinal staging for clinical N1-3 NSCLC.  The authors found that EBUS had superior accuracy (93% vs 89%) and negative predictive value (85% vs 79%). 
Identification of Independent Primary Tumors and Intrapulmonary Metastases Using DNA Rearrangements in Non-Small-Cell Lung Cancer
November 11, 2014
Differentiating a primary lung cancer from an intrapulmonary metastasis can be challenging.  The authors developed a lineage test using whole genome amplification and next-generation sequencing to identify breakpoints in known primary tumors and known metastases.  Independent primary tumors did not share any genomic rearrangements, whereas primary tu
Accuracy of FDG-PET to Diagnose Lung Cancer in Areas With Infectious Lung Disease
September 25, 2014
This meta-analysis of 70 studies evaluated the utility of PET in assessing over 8,511 lung nodules, comparing regions in which infectious lung disease is endemic to other regions.  Specificity was lower in regions with endemic infectious diseases, 61% vs 77%.  Overall, the accuracy of PET was extremely heterogeneous.
Test performance of PET-CT for mediastinal lymph node staging of pulmonary carcinoid tumours
August 15, 2014
This retrospective study involving 7 institutions evaluated the utility of PET for mediastinal staging in patients who had undergone resection of pulmlonary carcinoid tumors and nodal dissection.  88% of pts had typical carcinoid tumors.  The sensitivity of PET was only 33%, whereas the specificity was 94%.   
Preoperative PET and the Reduction of Unnecessary Surgery Among Newly Diagnosed Lung Cancer Patients in a Community Setting
March 8, 2014
During the period 1997-2009, nearly 3,000 military veterans with NSCLC were evaluated regarding the utility of PET in staging their cancers.  PET use increased in frequency during the study period from 9% to 91%.  PET reduced the chance of unnecessary surgery by nearly 50%. 

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